Fostering accurate HIV/AIDS knowledge among unmarried youths in Cameroon: Do family environment and peers matter?

Directory of Open Access Journals (Sweden)

Kuate Defo Barthelemy

2011-05-01

Full Text Available Abstract Background The last three decades have seen a series of HIV interventions in sub-Saharan Africa. However, youths still have a mixture of correct and incorrect HIV/AIDS knowledge of transmission routes and prevention strategies. Previous studies have identified parents and peers as the most important socializing agents for youths. This paper assesses the relationships between family structure, family/peer communication about sexuality and accurate knowledge of transmission routes and prevention strategies. Methods Data were drawn from the Cameroon Family Life and Health Survey (CFHS conducted in 2002. The CFHS collected information on a representative sample of 4 950 people aged 10 years and over nested within 1 765 selected households from the 75 localities forming the administrative prefecture of Bandjoun, using detailed questionnaires about family, HIV/AIDS/STDs knowledge, sexual behaviors, contraception, health, media exposure, household assets and neighborhood characteristics. The survey cooperation rates were high (97%. For the purpose of this study, a sub-sample of 2 028 unmarried youths aged 12 - 29 years was utilized. Results Overall, 42% of respondents reported accurate knowledge of documented HIV transmission routes whereas 21% of them had inaccurate knowledge such as AIDS can be transmitted through mosquito bites or casual contact with an infected person. Only 9% of respondents were knowledgeable about all HIV prevention strategies. Multivariate analyses showed that family structure, communication with parents/guardians and peers about sexual topics were significantly associated with accurate HIV knowledge. Additionally, age, education, sexual experience and migration had significant effects on accurate knowledge. Finally, living in poor households and disadvantaged neighborhoods significantly increased inaccurate knowledge of HIV transmission modes and prevention strategies. Conclusions This paper evidenced the limited

Effects of peer education intervention on HIV/AIDS related sexual behaviors of secondary school students in Addis Ababa, Ethiopia: a quasi-experimental study.

Science.gov (United States)

Menna, Takele; Ali, Ahmed; Worku, Alemayehu

2015-09-07

Worldwide, about 50% of all new cases of HIV occur in youth between age 15 and 24 years. Studies in various sub-Saharan African countries show that both out of school and in school adolescents and youth are engaged in risky sexual behaviors. School-based health education has been a cornerstone of youth-focused HIV prevention efforts since the early 1990s. In addition, peer-based interventions have become a common method to effect important health-related behavior changes and address the HIV/AIDS pandemic. Thus, the aim of this study was to evaluate efficacy of peer education on changing HIV related risky sexual behaviors among school youth in Addis Ababa, Ethiopia. A quasi experimental study with peer education intervention was conducted in purposively selected four secondary schools (two secondary schools for the intervention and other two for the control group) in Addis Ababa, Ethiopia. Five hundred sixty students from randomly selected sections of grade 11 were assessed through anonymous questionnaires conducted in pre- and post-intervention periods. Pertinent data on socio-demographic and sexual behavior related factors were collected. The statistical packages used for data entry and analysis were epi-info version 3.5.4 and SPSS version 20.0 respectively. Chi-square test and multivariable logistic regressions were used for testing association between peer education intervention and sexual behaviors of students. In addition to testing association between dependent and independent variables, multi-variable analysis was employed to control for the effects of confounding variables. When the pre and post intervention data of each group were compared, comprehensive Knowledge of HIV (P-Values =0.004) and willingness to go for HIV counseling and testing (P-value = 0.01) showed significant differences among intervention group students during post intervention period. Moreover, students in the intervention group were more likely to use condoms during post

Empowering the people: Development of an HIV peer education model for low literacy rural communities in India

Directory of Open Access Journals (Sweden)

Krupp Karl

2008-04-01

Full Text Available Abstract Background Despite ample evidence that HIV has entered the general population, most HIV awareness programs in India continue to neglect rural areas. Low HIV awareness and high stigma, fueled by low literacy, seasonal migration, gender inequity, spatial dispersion, and cultural taboos pose extra challenges to implement much-needed HIV education programs in rural areas. This paper describes a peer education model developed to educate and empower low-literacy communities in the rural district of Perambalur (Tamil Nadu, India. Methods From January to December 2005, six non-governmental organizations (NGO's with good community rapport collaborated to build and pilot-test an HIV peer education model for rural communities. The program used participatory methods to train 20 NGO field staff (Outreach Workers, 102 women's self-help group (SHG leaders, and 52 barbers to become peer educators. Cartoon-based educational materials were developed for low-literacy populations to convey simple, comprehensive messages on HIV transmission, prevention, support and care. In addition, street theatre cultural programs highlighted issues related to HIV and stigma in the community. Results The program is estimated to have reached over 30 000 villagers in the district through 2051 interactive HIV awareness programs and one-on-one communication. Outreach workers (OWs and peer educators distributed approximately 62 000 educational materials and 69 000 condoms, and also referred approximately 2844 people for services including voluntary counselling and testing (VCT, care and support for HIV, and diagnosis and treatment of sexually-transmitted infections (STI. At least 118 individuals were newly diagnosed as persons living with HIV (PLHIV; 129 PLHIV were referred to the Government Hospital for Thoracic Medicine (in Tambaram for extra medical support. Focus group discussions indicate that the program was well received in the communities, led to improved health

Leveraging strong social ties among young men in Dar es Salaam: A pilot intervention of microfinance and peer leadership for HIV and gender-based violence prevention.

Science.gov (United States)

Maman, Suzanne; Kajula, Lusajo; Balvanz, Peter; Kilonzo, Mrema; Mulawa, Marta; Yamanis, Thespina

2016-12-01

Gender inequality is at the core of the HIV patterns that are evident in sub-Saharan Africa. Gender-based violence (GBV) and lack of economic opportunity are important structural determinants of HIV risk. We piloted a microfinance and health promotion intervention among social networks of primarily young men in Dar es Salaam. Twenty-two individuals participated in the microfinance component and 30 peer leaders were recruited and trained in the peer health leadership component. We collected and analysed observational data from trainings, monitoring data on loan repayment, and reports of peer conversations to assess the feasibility and acceptability of the intervention. Eighteen of the loan recipients (82%) paid back their loans, and of these 15 (83%) received a second, larger loan. Among the loan defaulters, one died, one had chronic health problems, and two disappeared, one of whom was imprisoned for theft. The majority of conversations reported by peer health leaders focused on condoms, sexual partner selection, and HIV testing. Few peer leaders reported conversations about GBV. We demonstrated the feasibility and acceptability of this innovative HIV and GBV prevention intervention. The lessons learned from this pilot have informed the implementation of a cluster-randomised trial of the microfinance and peer health leadership intervention.

The Effects of Peer Education on The Behaviors Regarding HIV/AIDS Transmission Prevention Among Street Children in Bandung City

Directory of Open Access Journals (Sweden)

Lia Meilianingsih

2017-07-01

Full Text Available All adolescents are vulnerable to HIV/AIDS, including street children. The behaviors of street children are much influenced by their peers. Peer education can enhance knowledge, attitudes, beliefs, and skills and empower children to be responsible for protecting the health of themselves and their peers (Wahyuni, 2012. This study aims to determine the effects of peer health education on the HIV/AIDS Preventive Behaviors of Street Children in Bandung City in 2015. The research employed a quasi-experimental method with the pre-post-test control group design. The sample was 26 people for the treatment group and 26 people for the control group, respectively, taken with purposive sampling technique. Interventions began with peer educator training and then the peer educators provided health education on HIV/AIDS transmission prevention through small group discussions for 2 days. The data in this study were not normally distributed. The paired or dependent data were analyzed using the Wilcoxon test, while the unpaired or independent data using Mann-Whitney test. The results of the research show that peer health education had effects on the knowledge and attitudes of the street children (p values 0.00 and 0.00, respectively; however, there was no effect of peer health education on the actions regarding HIV/AIDS transmission prevention among the street children (p value 0.09. Hence, it is advisable to conduct health promotion with peer health education method in an effort of increasing knowledge and attitudes regarding HIV/AIDS transmission prevention among street children that is sustainable and integrated with the existing programs at puskesmas (Community Health Center.

HIV risk inside U.S. prisons: a systematic review of risk reduction interventions conducted in U.S. prisons.

Science.gov (United States)

Valera, Pamela; Chang, Yvonne; Lian, Zi

2017-08-01

HIV prevalence in correctional populations is approximately five times that of the general adult population. This systematic review examines the broad question of HIV prevention and interventions to reduce inmate HIV-related risk behaviors in U.S. federal and state prisons. We conducted a systematic review of multiple databases and Google Scholar to identify behavioral, biomedical, social, and policy studies related to HIV among U.S. prison populations from 1980-2014. Studies were excluded if they did not focus on HIV, prison inmates, if they were conducted outside of the U.S., if they involved juvenile offenders, or if they included post-release outcomes. Twenty-seven articles met the study criteria. Evidence suggests that research related to the HIV care continuum, risk behaviors, gender, prevention (e.g., peer education), and policy are key topics to enhance HIV prevention interventions in the criminal justice system. This review provides a prison-specific overview of HIV in U.S. correctional populations and highlight effective interventions, including inmate peer education. There is an urgent need to continue to implement HIV prevention interventions across all prisons and improve the quality of life among those at heightened risk of HIV infection.

The intersection of antiretroviral therapy, peer support programmes, and economic empowerment with HIV stigma among HIV-positive women in West Nile Uganda.

Science.gov (United States)

Kellett, Nicole Coffey; Gnauck, Katherine

2016-12-01

HIV stigma remains a major problem of the AIDS epidemic in sub-Saharan Africa. Women fear impending social stigma including blame, isolation and abuse. HIV infection and HIV stigma interact cyclically, creating and reinforcing economic and social exclusion for individuals living with HIV. Evidence suggests that interventions for people living with HIV infection that include, in combination, antiretroviral therapy (ART), peer support and economic empowerment are likely to be more effective than if used alone. We report a qualitative study in West Nile Uganda that explored perceptions of HIV stigma among fifty-four HIV-positive women who had similar access to ART and HIV peer support programmes, but varying levels of participation (full-time, intermittent, none) in economic empowerment programmes. Our study found that access to ART, peer support groups, and economic empowerment programmes helped to curb perceptions of deep-seated HIV stigma for participants. More expressions of usefulness, hope and psychological well-being prevailed with participants who had increased participation in economic empowerment programmes. Our findings underscore the value of HIV outreach programmes which combine ART, peer support and economic empowerment to alleviate HIV stigma. Further research to quantify the interaction of these factors is warranted.

Using Peer-Referral Chains with Incentives to Promote HIV Testing and Identify Undiagnosed HIV Infections Among Crack Users in San Salvador.

Science.gov (United States)

Glasman, Laura R; Dickson-Gomez, Julia; Lechuga, Julia; Tarima, Sergey; Bodnar, Gloria; de Mendoza, Lorena Rivas

2016-06-01

In El Salvador, crack users are at high risk for HIV but they are not targeted by efforts to promote early HIV diagnosis. We evaluated the promise of peer-referral chains with incentives to increase HIV testing and identify undiagnosed HIV infections among networks of crack users in San Salvador. For 14 months, we offered HIV testing in communities with a high prevalence of crack use. For the following 14 months, we promoted chains in which crack users from these communities referred their peers to HIV testing and received a small monetary incentive. We recorded the monthly numbers of HIV testers, and their crack use, sexual risk behaviors and test results. After launching the referral chains, the monthly numbers of HIV testers increased significantly (Z = 6.90, p < .001) and decayed more slowly (Z = 5.93, p < .001), and the total number of crack-using testers increased nearly fourfold. Testers in the peer-referral period reported fewer HIV risk behaviors, but a similar percentage (~5 %) tested HIV positive in both periods. More women than men received an HIV-positive diagnosis throughout the study (χ(2)(1, N = 799) = 4.23, p = .040). Peer-referral chains with incentives can potentially increase HIV testing among networks of crack users while retaining a focus on high-risk individuals.

Impact of HIV Information and Peer Support on Psychiatric ...

African Journals Online (AJOL)

Background: Young people are most vulnerable to acquiring HIV Infection in Zambia and they are at increased risk of developing psychiatric disorders which if left unchecked can have behavioural and health consequences. It's from this background that this study aimed at evaluating the impact of HIV information and peer ...

Qualitative insights into implementation, processes, and outcomes of a randomized trial on peer support and HIV care engagement in Rakai, Uganda.

Science.gov (United States)

Monroe, April; Nakigozi, Gertrude; Ddaaki, William; Bazaale, Jeremiah Mulamba; Gray, Ronald H; Wawer, Maria J; Reynolds, Steven J; Kennedy, Caitlin E; Chang, Larry W

2017-01-10

People living with human immunodeficiency virus (HIV) who have not yet initiated antiretroviral therapy (ART) can benefit from being engaged in care and utilizing preventive interventions. Community-based peer support may be an effective approach to promote these important HIV services. After conducting a randomized trial of the impact of peer support on pre-ART outcomes, we conducted a qualitative evaluation to better understand trial implementation, processes, and results. Overall, 75 participants, including trial participants (clients), peer supporters, and clinic staff, participated in 41 in-depth interviews and 6 focus group discussions. A situated Information Motivation, and Behavioral skills model of behavior change was used to develop semi-structured interview and focus group guides. Transcripts were coded and thematically synthesized. We found that participant narratives were generally consistent with the theoretical model, indicating that peer support improved information, motivation, and behavioral skills, leading to increased engagement in pre-ART care. Clients described how peer supporters reinforced health messages and helped them better understand complicated health information. Peer supporters also helped clients navigate the health system, develop support networks, and identify strategies for remembering medication and clinic appointments. Some peer supporters adopted roles beyond visiting patients, serving as a bridge between the client and his or her family, community, and health system. Qualitative results demonstrated plausible processes by which peer support improved client engagement in care, cotrimoxazole use, and safe water vessel use. Challenges identified included insufficient messaging surrounding ART initiation, lack of care continuity after ART initiation, rare breaches in confidentiality, and structural challenges. The evaluation found largely positive perceptions of the peer intervention across stakeholders and provided valuable

Reproductive health for refugees by refugees in Guinea IV: Peer education and HIV knowledge, attitudes, and reported practices

Directory of Open Access Journals (Sweden)

von Roenne Anna

2011-07-01

Full Text Available Abstract Background Both conflict and HIV affect sub-Saharan Africa, and supportive approaches for HIV prevention among refugees are crucial. Peer education has been associated with improved HIV outcomes, though relatively little research has been published on refugee settings. The primary objective of this study was to assess whether exposure to refugee peer education was associated with improved HIV knowledge, attitudes, or practice outcomes among refugees in Guinea. Secondary objectives were to assess whether gender, age, or formal education were more strongly associated than peer education with improved HIV outcomes. Methods Data was collected by cross-sectional survey from 889 reproductive-age men and women in 23 camps in the Forest Region of Guinea. Selected exposures (i.e. peer education, gender, formal education, age were analysed for associations with HIV outcomes using logistic regression odds ratios (OR. Results Most participants (88% had heard of HIV, particularly those exposed to peer or formal education. Most correctly identified ways to protect themselves, while maintaining misconceptions about HIV transmission. Women and those exposed to either peer or formal education had significantly fewer misconceptions. Half of participants considered themselves at risk of HIV, women with 52% higher odds than men (adjusted OR 1.52, 95%CI 1.01-2.29. Participants exposed to peer education had more than twice the odds of reporting having made HIV-avoidant behavioural changes than unexposed participants (72% versus 58%; adjusted OR 2.49, 95%CI 1.52-4.08. While women had 57% lower odds than men of reporting HIV-avoidant behavioural changes (OR 0.43, 95%CI 0.31-0.60, women exposed to peer education had greater odds than exposed men of reporting HIV-avoidant changes (OR 2.70 versus OR 1.95. Staying faithful (66% was the most frequent behavioural change reported. Conclusions Peer education was most strongly associated with reported HIV

Evaluation of an HIV/AIDS peer education programme in a South ...

African Journals Online (AJOL)

Objectives. To evaluate a South African workplace HIV I AIDS peer-education programme running since 1997. Methods. In 2001 a cross-sectional study was done of 900 retail-section employees in three geographical areas. The study measured HIV I AIDS knowledge, attitudes towards people living with HIV I AIDS, belief ...

Peer led HIV/AIDS prevention for women in South African informal settlements.

Science.gov (United States)

O'Hara Murdock, Peggy; Garbharran, Hari; Edwards, Mary Jo; Smith, Maria A; Lutchmiah, Johnny; Mkhize, Makhosi

2003-07-01

South African women who live in informal settlement communities are at high risk of HIV/AIDS infection due to their poor economic and social status. Prevention programs must include methods for improving their social conditions as well as their sexual risk behaviors. Members of Partners trained 24 women from informal settlements to lead HIV/AIDS education workshops for 480 residents. When these participants reached out to their neighbors, this participatory community-based approach resulted in providing HIV/AIDS prevention messages to more than 1,440 residents. Program leaders from three settlements said in focus group discussions that results from this social influences peer led approach demonstrated that women residents are a valuable resource in providing effective HIV/AIDS prevention programs to South Africa's most vulnerable residents.

Exploring experiences in peer mentoring as a strategy for capacity building in sexual reproductive health and HIV service integration in Kenya.

Science.gov (United States)

Ndwiga, Charity; Abuya, Timothy; Mutemwa, Richard; Kimani, James Kelly; Colombini, Manuela; Mayhew, Susannah; Baird, Averie; Muia, Ruth Wayua; Kivunaga, Jackline; Warren, Charlotte E

2014-03-01

The Integra Initiative designed, tested, and adapted protocols for peer mentorship in order to improve service providers' skills, knowledge, and capacity to provide quality integrated HIV and sexual and reproductive health (SRH) services. This paper describes providers' experiences in mentoring as a method of capacity building. Service providers who were skilled in the provision of FP or PNC services were selected to undergo a mentorship training program and to subsequently build the capacity of their peers in SRH-HIV integration. A qualitative assessment was conducted to assess provider experiences and perceptions about peer mentoring. In-depth interviews were conducted with twelve mentors and twenty-three mentees who were trained in SRH and HIV integration. Interviews were recorded, transcribed, and imported to NVivo 9 for analysis. Thematic analysis methods were used to develop a coding framework from the research questions and other emerging themes. Mentorship was perceived as a feasible and acceptable method of training among mentors and mentees. Both mentors and mentees agreed that the success of peer mentoring largely depended on cordial relationship and consensus to work together to achieve a specific set of skills. Mentees reported improved knowledge, skills, self-confidence, and team work in delivering integrated SRH and HIV services as benefits associated with mentoring. They also associated mentoring with an increase in the range of services available and the number of clients seeking those services. Successful mentorship was conditional upon facility management support, sufficient supplies and commodities, a positive work environment, and mentors selection. Mentoring was perceived by both mentors and mentees as a sustainable method for capacity building, which increased providers' ability to offer a wide range of and improved access to integrated SRH and HIV services.

Underutilisation of routinely collected data in the HIV programme in Zambia: a review of quantitatively analysed peer-reviewed articles.

Science.gov (United States)

Munthali, Tendai; Musonda, Patrick; Mee, Paul; Gumede, Sehlulekile; Schaap, Ab; Mwinga, Alwyn; Phiri, Caroline; Kapata, Nathan; Michelo, Charles; Todd, Jim

2017-06-13

The extent to which routinely collected HIV data from Zambia has been used in peer-reviewed published articles remains unexplored. This paper is an analysis of peer-reviewed articles that utilised routinely collected HIV data from Zambia within six programme areas from 2004 to 2014. Articles on HIV, published in English, listed in the Directory of open access journals, African Journals Online, Google scholar, and PubMed were reviewed. Only articles from peer-reviewed journals, that utilised routinely collected data and included quantitative data analysis methods were included. Multi-country studies involving Zambia and another country, where the specific results for Zambia were not reported, as well as clinical trials and intervention studies that did not take place under routine care conditions were excluded, although community trials which referred patients to the routine clinics were included. Independent extraction was conducted using a predesigned data collection form. Pooled analysis was not possible due to diversity in topics reviewed. A total of 69 articles were extracted for review. Of these, 7 were excluded. From the 62 articles reviewed, 39 focused on HIV treatment and retention in care, 15 addressed prevention of mother-to-child transmission, 4 assessed social behavioural change, and 4 reported on voluntary counselling and testing. In our search, no articles were found on condom programming or voluntary male medical circumcision. The most common outcome measures reported were CD4+ count, clinical failure or mortality. The population analysed was children in 13 articles, women in 16 articles, and both adult men and women in 33 articles. During the 10 year period of review, only 62 articles were published analysing routinely collected HIV data in Zambia. Serious consideration needs to be made to maximise the utility of routinely collected data, and to benefit from the funds and efforts to collect these data. This could be achieved with government support

Combination HIV Prevention Strategy Implementation in El Salvador: Perceived Barriers and Adaptations Reported by Outreach Peer Educators and Supervisors

Directory of Open Access Journals (Sweden)

Meredith Buck

2017-04-01

Full Text Available El Salvador was one of three countries to receive funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria to conduct a combination HIV prevention intervention among transwomen (TW, men who have sex with men (MSM, and commercial sex workers (CSW. Program evaluation revealed that prevention activities reached only 50% of the target population. The purpose of this study is to examine the barriers that Salvadoran educators faced in implementing the peer education as designed and adaptations made as a result. Between March and June 2015, 18 in-depth interviews with educators were conducted. Violence was reported as the biggest barrier to intervention implementation. Other barriers differed by subpopulation. The level of violence and discrimination calls into question the feasibility and appropriateness of peer-led interventions in the Salvadoran context and demonstrates the importance of implementation research when translating HIV prevention interventions developed in high-income countries to low- and middle-income countries.

Evaluation of an HIV/AIDS peer education programme South African ...

African Journals Online (AJOL)

HIV I AIDS peer-education programme for its employees aimed at addressing the growing ..... m:JI education intervention in a mining community reports essentially no effect.17 ... yet to be determined. Such data are crucial for the development.

Shaping Understanding of HIV through Negotiation and Conflict Resolution during Peer Group Discussion

Science.gov (United States)

Patel, Vimla L.; Branch, Timothy; Gutnik, Lily; Arocha, Jose F.

2006-01-01

High-risk behavior in youths related to HIV transmission continues to occur despite large-scale efforts to disseminate information about safe sexual practices through education. Our study examined the relationships among knowledge, decision-making strategies, and risk assessment about HIV by youths during peer group focused discussions. Two focus…

HIV-infected individuals who delay, decline, or discontinue antiretroviral therapy: Comparing clinic- and peer-recruited cohorts

Directory of Open Access Journals (Sweden)

Marya eGwadz

2014-07-01

Full Text Available A substantial proportion of persons living with HIV/AIDS (PLHA delay, decline, or discontinue antiretroviral therapy (ART when it is medically indicated (40-45%, largely African Americans and Latinos/Hispanics. This study explores the feasibility of locating PLHA who are not on ART (PLHA-NOA through clinics and peer referral; compares the two cohorts on multi-level barriers to ART; and examines readiness to initiate/reinitiate ART, a predictor of treatment outcomes. We recruited adult HIV-infected African American and Latino/Hispanic PLHA-NOA through HIV hospital clinics and peer referral in 2012-13. Participants engaged in structured one-hour assessments with reliable/valid measures on barriers to ART. We found recruitment through peers (63.2%, 60/95 was more feasible than in clinics (36.8%, 35/90. Participants were 48.0 years old and had lived with HIV for 14.7 years on average, and 56.8% had taken ART previously. Most (61.1% were male and African American (76.8%, and 23.2% were Latino/Hispanic. Peer-recruited participants were older, had lived with HIV longer, were less engaged in HIV care, and were more likely to have taken ART previously. The cohorts differed in reasons for discontinuing ART. Levels of ART knowledge were comparable between cohorts (68.5% correct, and there were no differences in attitudes toward ART (e.g., mistrust, which were in the neutral range. In bivariate linear regression, readiness for ART was negatively associated with physician mistrust (B=-10.4, and positively associated with self-efficacy (B=5.5, positive outcome expectancies (B=6.3, beliefs about personal necessity of ART (B=17.5, and positive internal norms (B=7.9. The present study demonstrates the feasibility of engaging this vulnerable population through peer referral. Peer-recruited PLHA evidence particularly high rates of risk factors compared those in clinics. Interventions to support ART initiation and continuation are sorely needed for both subgroups.

All Aboard the Desistance Line: First Stop, Producing Prosocial Prison Attachments within an HIV Prison-Based Peer Program

Science.gov (United States)

Collica-Cox, Kimberly

2016-01-01

This article explores the importance of social bonds in facilitating an investment in prosocial behavior amongst female prisoners working as HIV peer educators. Female prisoners can lack strong prosocial attachments to both individuals and institutions prior to incarceration. Absent this bond, little prevents the female prisoner from recidivating.…

Attitudinal Changes Using Peer Education Training in the Prevention of HIV/AIDS: A Case Study of Youths in North Central Nigeria

Directory of Open Access Journals (Sweden)

Kamaldeen Abu-Saeed

2013-02-01

Full Text Available Purpose: HIV/AIDS is a major public health issue. Studies have shown that young people between the ages of 15 to 24 years accounts for more than 40% of new HIV infections. However, new infections could be prevented if the desired impact is made on young people through interventions such as effective peer education program to improve their knowledge, attitude and practice. Therefore, this study is aimed at assessing the impact of peer education vis-a-vis attitudinal changes and practices on issues relating to HIV/AIDS among youths in North central Nigeria. Methods: This classical experimental study was carried out in three stages, that is: pre-intervention, intervention and post-intervention stages among students of Government High School, Ilorin between the ages of 15 and 24 years. The sample size was 80 students each for study and control groups. Proportional gender distribution was ensured in the selection and the sampling technique was multistage sampling technique. Data collection was through semi structured self administered pre and post evaluation questionnaire. Peer education training and forth night mentoring sessions was conducted for the study group. Impact of the intervention was assessed after eight weeks. Results: Analysis of the result shows that out of the sixteen questions asked on respondents‟ attitude, only four showed statistical significance between the study and control group before the intervention which shot up to eleven after intervention. Also, the frequency of those having bad practices regarding prevention of HIV/AIDS also reduced after intervention. This reduction was much more in many instances when compared to the control group. Conclusion: This study has revealed that peer education training among youth can go a long way in educating them on issues relating to HIV/AIDS prevention. It can also bring about attitudinal changes and better practices that may help in reducing incidence and prevalence of HIV/AIDS in our

Envisioning Women-Centered HIV Care: Perspectives from Women Living with HIV in Canada.

Science.gov (United States)

O'Brien, Nadia; Greene, Saara; Carter, Allison; Lewis, Johanna; Nicholson, Valerie; Kwaramba, Gladys; Ménard, Brigitte; Kaufman, Elaina; Ennabil, Nourane; Andersson, Neil; Loutfy, Mona; de Pokomandy, Alexandra; Kaida, Angela

Women comprise nearly one-quarter of people living with human immunodeficiency virus (HIV) in Canada. Compared with men, women living with HIV experience inequities in HIV care and health outcomes, prompting a need for gendered and tailored approaches to HIV care. Peer and academic researchers from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study conducted focus groups to understand women's experience of seeking care, with the purpose of identifying key characteristics that define a women-centered approach to HIV care. Eleven focus groups were conducted with 77 women living with HIV across Quebec, Ontario, and British Columbia, Canada. Women envisioned three central characteristics of women-centered HIV care, including i) coordinated and integrated services that address both HIV and women's health care priorities, and protect against exclusion from care due to HIV-related stigma, ii) care that recognizes and responds to structural barriers that limit women's access to care, such as violence, poverty, motherhood, HIV-related stigma, and challenges to safe disclosure, and iii) care that fosters peer support and peer leadership in its design and delivery to honor the diversity of women's experiences, overcome women's isolation, and prioritize women's ownership over the decisions that affect their lives. Despite advances in HIV treatment and care, the current care landscape is inadequate to meet women's comprehensive care needs. A women-centered approach to HIV care, as envisioned by women living with HIV, is central to guiding policy and practice to improve care and outcomes for women living with HIV in Canada. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Effects of a school-based sexuality education program on peer educators: the Teen PEP model

OpenAIRE

Jennings, J. M.; Howard, S.; Perotte, C. L.

2014-01-01

This study evaluated the impact of the Teen Prevention Education Program (Teen PEP), a peer-led sexuality education program designed to prevent unintended pregnancy and sexually transmitted infections (STIs) including HIV among high school students. The study design was a quasi-experimental, nonrandomized design conducted from May 2007 to May 2008. The sample consisted of 96 intervention (i.e. Teen PEP peer educators) and 61 comparison students from five high schools in New Jersey. Baseline a...

Bereavement, silence and culture within a peer-led HIV/AIDS ...

African Journals Online (AJOL)

The argument draws on a number of qualitative studies and uses empirical evidence from an evaluation of a peer-led HIV/AIDS-prevention strategy aimed at providing psychosocial support for 10- to 13-year-old South African children living in resource-poor communities. The paper reveals a central paradox regarding how ...

Effective peer education in HIV: defining factors that maximise success.

Science.gov (United States)

Lambert, Steven M; Debattista, Joseph; Bodiroza, Aleksandar; Martin, Jack; Staunton, Shaun; Walker, Rebecca

2013-08-01

Background Peer education is considered an effective health promotion and education strategy, particularly to populations traditionally resistant to conventional forms of health information dissemination. This has made it very applicable to HIV education and prevention, where those who are affected or at risk are often amongst the most vulnerable in society. However, there still remains uncertainty as to the reasons for its effectiveness, what constitutes an effective methodology and why a consistent methodology can often result in widely variable outcomes. Between 2008 and 2010, three separate reviews of peer education were undertaken across more than 30 countries in three distinct geographical regions across the globe. The reviews sought to identify determinants of the strengths and weaknesses inherent in approaches to peer education, particularly targeting young people and the most at-risk populations. By assessing the implementation of peer education programs across a variety of social environments, it was possible to develop a contextual understanding for peer education's effectiveness and provide a picture of the social, cultural, political, legal and geographic enablers and disablers to effective peer education. Several factors were significant contributors to program success, not as strategies of methodology, but as elements of the social, cultural, political and organisational context in which peer education was situated. Contextual elements create environments supportive of peer education. Consequently, adherence to a methodology or strategy without proper regard to its situational context rarely contributes to effective peer education.

The development of peer educator-based harm reduction programmes in Northern Vietnam.

Science.gov (United States)

Walsh, Nick; Gibbie, Tania M; Higgs, Peter

2008-03-01

Injecting drug use remains an important risk factor for transmission in Vietnam, with an estimated 50% of the 290 000 people living with HIV/AIDS reporting injecting drug use as a risk factor. Despite this, effective harm reduction interventions are generally lacking. This paper describes the implementation of peer-based harm reduction programmes in two rural provinces of Vietnam. Peer educators were trained in basic HIV prevention, including harm reduction. After significant preparation work with the Provincial AIDS Committees of Bac Giang and Thanh Hoa and other relevant national, provincial and local authorities, the interventions were commenced. Harm reduction interventions were delivered through outreach as well as on-site. This included needle and syringe distribution and collection. Community advocacy occurred throughout the life of the project. Local authorities and peers believed that while there was a general reduction in stigma and discrimination, legal barriers associated particularly with the carrying of injecting equipment remained. This impacted upon the ability of peer educators to work with their clients. Peer-based delivery of harm reduction intervention is acceptable. Harm reduction interventions, including needle and syringe programmes, are feasible and acceptable in these two rural Vietnamese provinces. Community acceptance and uptake of these interventions is key to successful expansion across the region. Active participation by families of drug users seems crucial. This initiative demonstrates that despite a difficult policy environment, peer-delivered needle and syringe programmes are feasible within a rural Asian environment as long as there is adequate local political and community support.

Addressing adolescents’ risk and protective factors related to risky behaviours: Findings from a school-based peer-education evaluation in the Western Cape

Directory of Open Access Journals (Sweden)

Furzana Timol

2016-01-01

Full Text Available Background: Peer-education programmes aim to bring about attitudinal and behavioural changes in their target audience. In the South African educational context, peer education is a favoured approach in dealing with issues such as HIV and AIDS, sexual decision-making and substance misuse. Given the reliance on peer-education programmes in the educational system, it is important to establish how well they are working. This study aims to assess the effect of an extensive, structured, time-limited, curriculum-based, peer-led educational programme on first-year high school learners in public schools in the Western Cape Province of South Africa. Method: The curriculum called ‘Listen Up’ addresses issues such as supporting peers, sexual decision-making, healthy relationships, HIV risk, alcohol misuse and unwanted pregnancy in seven structured sessions. The programme targeted adolescents in Grade 8 growing up in what are considered to be risky environments in public schools in the Western Cape during 2012 and 2013. The intervention was evaluated based on 10 scales sourced from published literature related to the outcome indicators of future orientation, sensation-seeking, self-efficacy in sexual relations, HIV transmission knowledge, HIV prevention knowledge, HIV attitudes, sexual attitudes, decision-making, healthy relationships and social support. Descriptive statistics were used to analyse demographic and community characteristics and analyses of variance were used to detect differences between groups. The surveys were administered to a total of 7709 learners across three waves of the study in 27 peer intervention schools and eight control schools. Results: Immediately post intervention, statistically significant differences were noted for the intervention schools when compared to their baseline levels on measures of future orientation, self-efficacy in sexual relations, knowledge regarding HIV transmission, knowledge regarding HIV prevention and

Addressing adolescents' risk and protective factors related to risky behaviours: Findings from a school-based peer-education evaluation in the Western Cape.

Science.gov (United States)

Timol, Furzana; Vawda, Mohammed Yacoob; Bhana, Arvin; Moolman, Benita; Makoae, Mokhantso; Swartz, Sharlene

2016-12-01

Peer-education programmes aim to bring about attitudinal and behavioural changes in their target audience. In the South African educational context, peer education is a favoured approach in dealing with issues such as HIV and AIDS, sexual decision-making and substance misuse. Given the reliance on peer-education programmes in the educational system, it is important to establish how well they are working. This study aims to assess the effect of an extensive, structured, time-limited, curriculum-based, peer-led educational programme on first-year high school learners in public schools in the Western Cape Province of South Africa. The curriculum called 'Listen Up' addresses issues such as supporting peers, sexual decision-making, healthy relationships, HIV risk, alcohol misuse and unwanted pregnancy in seven structured sessions. The programme targeted adolescents in Grade 8 growing up in what are considered to be risky environments in public schools in the Western Cape during 2012 and 2013. The intervention was evaluated based on 10 scales sourced from published literature related to the outcome indicators of future orientation, sensation-seeking, self-efficacy in sexual relations, HIV transmission knowledge, HIV prevention knowledge, HIV attitudes, sexual attitudes, decision-making, healthy relationships and social support. Descriptive statistics were used to analyse demographic and community characteristics and analyses of variance were used to detect differences between groups. The surveys were administered to a total of 7709 learners across three waves of the study in 27 peer intervention schools and eight control schools. Immediately post intervention, statistically significant differences were noted for the intervention schools when compared to their baseline levels on measures of future orientation, self-efficacy in sexual relations, knowledge regarding HIV transmission, knowledge regarding HIV prevention and knowledge in terms of healthy relationships

Effects of a School-Based Sexuality Education Program on Peer Educators: The Teen PEP Model

Science.gov (United States)

Jennings, J. M.; Howard, S.; Perotte, C. L.

2014-01-01

This study evaluated the impact of the Teen Prevention Education Program (Teen PEP), a peer-led sexuality education program designed to prevent unintended pregnancy and sexually transmitted infections (STIs) including HIV among high school students. The study design was a quasi-experimental, nonrandomized design conducted from May 2007 to May…

Effects of Peer Education on the Knowledge and use of HIV ...

African Journals Online (AJOL)

Although HIV counselling and testing (HCT) service plays important roles in prevention and control of AIDS, many young Nigerians under-utilize it. A peer education intervention was implemented to promote use of HCT among secondary school students and apprentices in Ibadan, Nigeria. Baseline data were collected from ...

Associations Between Sexual Risk-Related Behaviors and School-Based Education on HIV and Condom Use for Adolescent Sexual Minority Males and Their Non-Sexual-Minority Peers.

Science.gov (United States)

Rasberry, Catherine N; Condron, D Susanne; Lesesne, Catherine A; Adkins, Susan Hocevar; Sheremenko, Ganna; Kroupa, Elizabeth

2018-01-01

With HIV and sexually transmitted disease (STD) rates disproportionately high among adolescent sexual minority males (ASMM), it is important to understand how school-based sexual health education may relate to sexual risk-related behavior among this population. This analysis explores reported HIV/AIDS- and condom-related education and sexual risk-related behaviors among ASMM and their adolescent non-sexual-minority male (non-ASMM) peers. Students (n = 11,681) from seven Florida high schools completed paper-and-pencil questionnaires. A matched analytic sample of ASMM and non-ASMM students was created by using propensity score-matching techniques (n = 572). Logistic regressions controlling for individual and school characteristics examined reporting having been taught about AIDS or HIV in school, having been taught in school about using condoms, condom use at last sex, HIV/STD testing, and associations between these variables. Compared with matched non-ASMM peers, ASMM students were less likely to report having been taught about AIDS or HIV in school (odds ratio [OR] = 0.58, P = 0.04) and having used a condom at last sex (OR = 0.39, P condoms. Among non-ASMM, reporting having been taught in school about using condoms was associated with a greater likelihood of condom use at last sex (OR = 4.78, P education and differential associations between condom-related education and condom use in ASMM and non-ASMM suggest that sexual health education in schools may not be resonating with ASMM and non-ASMM in the same way.

Patterns of HIV testing, drug use, and sexual behaviors in people who use drugs: findings from a community-based outreach program in Phnom Penh, Cambodia.

Science.gov (United States)

Mburu, Gitau; Ngin, Chanrith; Tuot, Sovannary; Chhoun, Pheak; Pal, Khuondyla; Yi, Siyan

2017-12-05

People who use drugs are an important priority for HIV programs. However, data related to their utilization of HIV services are limited. This paper reports patterns of HIV testing, drug use, and risk and service perception among people who use drugs. Study participants were receiving HIV and harm reduction services from a community-based program in Phnom Penh, comprised of itinerant peer-led outreach and static drop-in centers. This was a mixed-methods study conducted in 2014, comprising of a quantitative survey using a structured questionnaire, followed by two focus group discussions among a sub-sample of survey participants. Participants were recruited from hotspots in five HIV high-burden communes using a two-stage cluster sampling method. Quantitative descriptive analyses and qualitative thematic analyses were performed. This study included 151 people who use drugs with a mean age of 31.2 (SD = 6.5) years; 77.5% were male and 39.1% were married. The most common drugs used were methamphetamines (72.8%) and heroin (39.7%), and 38.0% injected drugs in the past 3 months. Overall, 83.3% had been tested for HIV in the past 6 months, of whom 62.5% had been tested by peers through community-based outreach. However, there were ongoing HIV risks: 37.3% were engaging in sex on drugs, only 35.6% used a condom at last sexual intercourse, and 10.8% had had a sexually transmitted infection in the last 6 months. Among people who reported injecting drugs in the past 3 months, 27.5% reported re-using needles/syringes. Almost half (46.5%) perceived themselves as being at lower risk of HIV compared to the general population. Qualitative results contextualized the findings of low perception of HIV risks and suggested that although services were often unavailable on weekends, at night, or during national holidays, peer-led community-based outreach was highly accepted. A peer-led community-based approach was effective in reaching people who use drugs with HIV and harm reduction

Zambian Peer Educators for HIV Self-Testing (ZEST) study: rationale and design of a cluster randomised trial of HIV self-testing among female sex workers in Zambia.

Science.gov (United States)

Oldenburg, Catherine E; Ortblad, Katrina F; Chanda, Michael M; Mwanda, Kalasa; Nicodemus, Wendy; Sikaundi, Rebecca; Fullem, Andrew; Barresi, Leah G; Harling, Guy; Bärnighausen, Till

2017-04-20

HIV testing and knowledge of status are starting points for HIV treatment and prevention interventions. Among female sex workers (FSWs), HIV testing and status knowledge remain far from universal. HIV self-testing (HIVST) is an alternative to existing testing services for FSWs, but little evidence exists how it can be effectively and safely implemented. Here, we describe the rationale and design of a cluster randomised trial designed to inform implementation and scale-up of HIVST programmes for FSWs in Zambia. The Zambian Peer Educators for HIV Self-Testing (ZEST) study is a 3-arm cluster randomised trial taking place in 3 towns in Zambia. Participants (N=900) are eligible if they are women who have exchanged sex for money or goods in the previous 1 month, are HIV negative or status unknown, have not tested for HIV in the previous 3 months, and are at least 18 years old. Participants are recruited by peer educators working in their communities. Participants are randomised to 1 of 3 arms: (1) direct distribution (in which they receive an HIVST from the peer educator directly); (2) fixed distribution (in which they receive a coupon with which to collect the HIVST from a drug store or health post) or (3) standard of care (referral to existing HIV testing services only, without any offer of HIVST). Participants are followed at 1 and 4 months following distribution of the first HIVST. The primary end point is HIV testing in the past month measured at the 1-month and 4-month visits. This study was approved by the Institutional Review Boards at the Harvard T.H. Chan School of Public Health in Boston, USA and ERES Converge in Lusaka, Zambia. The findings of this trial will be presented at local, regional and international meetings and submitted to peer-reviewed journals for publication. Pre-results; NCT02827240. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Workplace peer educators and stress.

Science.gov (United States)

Dickinson, David; Kgatea, Kabelo Duncan

2008-11-01

Peer educators form an important component of company responses to HIV and AIDS. Based on interviews with peer educators working in and around a mining company in South Africa's North-West Province, the study examines the relationship between involvement in peer education and stress. The paper discusses how becoming a peer educator can be a response to the often personal stress brought about by the HIV epidemic. In addition, structural difficulties, skills deficiencies and other obstacles to effective communication with their peers can create stress. The stress that active peer education brings to individuals is discussed, particularly in regard to the embeddedness of peer educators within their communities. The need for confidentiality also magnifies stress in the case of individuals who disregard peer educators' advice. Peer educators face many stresses in managing and supporting their own lives, thus their (voluntary) work as peer educators should not be taken out of context. Using this approach, we discuss how the role of peer educator should be conceptualised and how they can be organised and supported in order that their stress be minimised and effective engagement maximised.

The HIV and Drug Abuse Prevention Research Ethics Training Institute: Training Early-Career Scientists to Conduct Research on Research Ethics

Science.gov (United States)

Fisher, Celia B.; Yuko, Elizabeth

2018-01-01

The responsible conduct of HIV/drug abuse prevention research requires investigators with both the knowledge of and ability to generate empirical data that can enhance global ethical practices and policies. This article describes a multidisciplinary program offering early-career professionals a 2-year intensive summer curriculum along with funding to conduct a mentored research study on a wide variety of HIV/drug abuse research ethics topics. Now in its fifth year, the program has admitted 29 trainees who have to date demonstrated increased knowledge of research ethics, produced 17 peer-reviewed publications, 46 professional presentations, and submitted or been awarded five related federal grants. The institute also hosts a global information platform providing general and HIV/drug abuse relevant research ethics educational and research resources that have had more than 38,800 unique visitors from more than 150 countries. PMID:26564944

Evaluation of the Effectiveness of Peer Education in Improving HIV Knowledge, Attitude, and Sexual Behaviours among In-School Adolescents in Osun State, Nigeria

Directory of Open Access Journals (Sweden)

Adeleye Abiodun Adeomi

2014-01-01

Full Text Available Introduction. Young people are at the centre of the global HIV/AIDS epidemic. This study therefore aimed to evaluate the effectiveness of peer education in improving HIV knowledge, attitude, and preventive practices among in-school adolescents in Osun State, Nigeria. Methods. This was an intervention study that was carried out among in-school adolescents attending mixed secondary schools in Osun State, Nigeria. The study was in three stages: before intervention, intervention, and after intervention. The impact of peer education was evaluated twelve weeks after intervention. Data were collected using pretested semistructured questionnaires and data analysis was done with SPSS version 16. Results. At the preintervention stage, the study and control groups were similar in their sociodemographic characteristics, HIV knowledge, attitude, and preventive practices, including high risk behaviours for HIV/AIDS transmission. After the peer education intervention, those with good knowledge and positive attitudes towards HIV/AIDS increased significantly from 50.0% to 86.7% and from 49.0% to 85.6%, respectively (P<0.05. Conclusion. The study showed that peer education is effective in improving knowledge, attitude, and some preventive practices towards HIV/AIDS among in-school adolescents. Educational programmes about HIV/AIDS should therefore be designed to target this age group putting into consideration their unique characteristics.

The HIV and Drug Abuse Prevention Research Ethics Training Institute: Training Early-Career Scientists to Conduct Research on Research Ethics.

Science.gov (United States)

Fisher, Celia B; Yuko, Elizabeth

2015-12-01

The responsible conduct of HIV/drug abuse prevention research requires investigators with both the knowledge of and ability to generate empirical data that can enhance global ethical practices and policies. This article describes a multidisciplinary program offering early-career professionals a 2-year intensive summer curriculum along with funding to conduct a mentored research study on a wide variety of HIV/drug abuse research ethics topics. Now in its fifth year, the program has admitted 29 trainees who have to date demonstrated increased knowledge of research ethics, produced 17 peer-reviewed publications, 46 professional presentations, and submitted or been awarded five related federal grants. The institute also hosts a global information platform providing general and HIV/drug abuse relevant research ethics educational and research resources that have had more than 38,800 unique visitors from more than 150 countries. © The Author(s) 2015.

A narrative review of undergraduate peer-based healthcare ethics teaching.

Science.gov (United States)

Hindmarch, Thomas; Allikmets, Silvia; Knights, Felicity

2015-12-12

This study explores the literature in establishing the value of undergraduate peer-based healthcare ethics teaching as an educational methodology. A narrative review of the literature concerning peer-based ethics teaching was conducted. MEDLINE, EMBASE, CINAHL, SCOPUS databases, and the Cochrane Library, were systematically searched for studies of peer-based ethics or professionalism teaching. Selected studies related peer-based teaching to ethics education outcomes. Ten publications were identified. Selected studies were varied in their chosen intervention methodology and analysis. Collectively, the identified studies suggest peer-based ethics education is an effective and valued educational methodology in training healthcare professionals. One paper suggests peer-based ethics teaching has advantages over traditional didactic methods. Peer-based ethics teaching also receives positive feedback from student participants. However, the limited literature base demonstrates a clear need for more evaluation of this pedagogy. The current literature base suggests that undergraduate peer based healthcare ethics teaching is valuable in terms of efficacy and student satisfaction. We conclude that the medical community should invest in further study in order to capitalise upon the potential of peer-based ethics teaching in undergraduate healthcare education.

Ethics issues in social media-based HIV prevention in low- and middle-income countries.

Science.gov (United States)

Chiu, Chingche J; Menacho, Luis; Fisher, Celia; Young, Sean D

2015-07-01

Questions have been raised regarding participants' safety and comfort when participating in e-health education programs. Although researchers have begun to explore this issue in the United States, little research has been conducted in low- and middle-income countries, where Internet and social media use is rapidly growing. This article reports on a quantitative study with Peruvian men who have sex with men who had previously participated in the Harnessing Online Peer Education (HOPE) program, a Facebook-based HIV education program. The survey assessed participants' ethics-relevant perspectives during recruitment, consent, intervention, and follow-up.

Impact of Beliefs about HIV Treatment and Peer Condom Norms on Risky Sexual Behavior among Gay and Bisexual Men

Science.gov (United States)

Peterson, John L.; Bakeman, Roger

2006-01-01

The association between perceptions about condom use among one's peers, beliefs about new HIV treatments, and HIV sexual risk behavior was examined in a large urban sample ( N = 454) of gay and bisexual men in the Southeast. Results partially confirmed the hypothesis that men who endorsed new HIV treatment beliefs would report lower norms for…

The attitudes of primary schoolchildren in Northern Thailand towards their peers who are affected by HIV and AIDS.

Science.gov (United States)

Ishikawa, Naoko; Pridmore, Pat; Carr-Hill, Roy; Chaimuangdee, Kreangkrai

2011-02-01

After more than a decade of the AIDS epidemic in Thailand, the number of children whose parents are living with HIV or have died from AIDS is increasing significantly and it has been reported that these children are often discriminated against by their peers. In order to better understand the current situation and to explore possible strategies to support HIV-affected children, this study examined children's attitudes towards HIV and AIDS using questionnaires and focus group discussions with children in Grades three-six in five primary schools in a northern province in Thailand. A total of 513 children (274 boys and 239 girls) answered the questionnaire and five focus groups were organised. The findings showed a strong positive correlation between children's belief that HIV could be transmitted through casual contact and their negative attitudes towards their HIV-affected peers. Most children overestimated the risk of HIV transmission through casual contact and this made their attitudes less tolerant and less supportive. After HIV prevention education (which included information on HIV transmission routes) was given in three of the study schools, the same questionnaire and focus groups were repeated and the findings showed that children's attitudes had become more supportive. These findings suggest that HIV prevention education delivered through primary schools in Thailand can be an effective way to help foster a more supportive and inclusive environment and reduce the stigma and discrimination that decrease educational access and attainment for HIV-affected schoolchildren.

Condom use peer norms and self-efficacy as mediators between community engagement and condom use among Chinese men who have sex with men

Directory of Open Access Journals (Sweden)

Haochu Li

2017-08-01

Full Text Available Abstract Background Community engagement strategies are often integrated in public health interventions designed to promote condom use among men who have sex with men (MSM, a key population for HIV prevention. However, the ways in which condom use peer norms and self-efficacy play a role in the association between community engagement and condom use is unclear. This study examines the potential mediating roles of peer norms and self-efficacy in this association. Methods A nationwide cross-sectional online survey was conducted among Chinese MSM in 2015. Recruitment criteria included being born biologically male, being older than 16 years, having had anal sex with a man at least once during their lifetime, and having had condomless anal or vaginal sex in the past three months. Mplus 6.11 was used to conduct confirmatory factor analysis and path modeling analysis to examine the structural relationships between HIV/sexual health community engagement (e.g., joining social media and community events related to HIV and sexual health services, condom use peer norms, condom use self-efficacy, and frequency of condom use. Results The study found that HIV/sexual health community engagement, condom use peer norms, condom use self-efficacy, and frequency of condom use were mutually correlated. A good data model was achieved with fit index: CFI = 0.988, TLI = 0.987, RMSEA = 0.032, 90% CI (0.028, 0.036. HIV/sexual health community engagement was associated with frequency of condom use, which was directly mediated by condom use peer norms and indirectly through self-efficacy. Conclusion The study suggests that condom use peer norms and self-efficacy may be mediators in the pathway between community engagement and condom use, and suggests the importance of peer-based interventions to improve condom use.

Condom use peer norms and self-efficacy as mediators between community engagement and condom use among Chinese men who have sex with men.

Science.gov (United States)

Li, Haochu; Xue, Li; Tucker, Joseph D; Wei, Chongyi; Durvasula, Maya; Hu, Wenqi; Kang, Dianming; Liao, Meizhen; Tang, Weiming; Ma, Wei

2017-08-07

Community engagement strategies are often integrated in public health interventions designed to promote condom use among men who have sex with men (MSM), a key population for HIV prevention. However, the ways in which condom use peer norms and self-efficacy play a role in the association between community engagement and condom use is unclear. This study examines the potential mediating roles of peer norms and self-efficacy in this association. A nationwide cross-sectional online survey was conducted among Chinese MSM in 2015. Recruitment criteria included being born biologically male, being older than 16 years, having had anal sex with a man at least once during their lifetime, and having had condomless anal or vaginal sex in the past three months. Mplus 6.11 was used to conduct confirmatory factor analysis and path modeling analysis to examine the structural relationships between HIV/sexual health community engagement (e.g., joining social media and community events related to HIV and sexual health services), condom use peer norms, condom use self-efficacy, and frequency of condom use. The study found that HIV/sexual health community engagement, condom use peer norms, condom use self-efficacy, and frequency of condom use were mutually correlated. A good data model was achieved with fit index: CFI = 0.988, TLI = 0.987, RMSEA = 0.032, 90% CI (0.028, 0.036). HIV/sexual health community engagement was associated with frequency of condom use, which was directly mediated by condom use peer norms and indirectly through self-efficacy. The study suggests that condom use peer norms and self-efficacy may be mediators in the pathway between community engagement and condom use, and suggests the importance of peer-based interventions to improve condom use.

Knowledge of HIV and willingness to conduct oral rapid HIV testing among dentists in Xi'an China.

Directory of Open Access Journals (Sweden)

Lirong Wang

Full Text Available China is considered a country of low HIV prevalence (780,000 people living with HIV, however, HIV infections among high-risk populations continue to grow at alarming rates. Voluntary Counseling and Testing services were first implemented in 2003, and oral rapid HIV testing (ORHT began in 2012. Dentists, as oral health experts, would be well placed to conduct ORHT. We assessed willingness of dentists to undertake ORHT in their clinical practice.A cross-sectional, paper-based survey of dentists from the Xi'an region of China was conducted from April to June 2013. Dentists were recruited from Shaanxi Stomatological Association using a stratified sampling methodology. A 40-item survey was used to measure knowledge of HIV, attitudes toward people living with HIV and willingness to conduct ORHT.477 dentists completed the survey with a mean HIV knowledge test score of 13.2/18 (SD 1.9. If made available in the dental setting, 276 (57.9% preferred to use blood to diagnose HIV, only 190 (39.8% preferred saliva or both. Four hundred and thirty-five (91.2% thought that ORHT was needed in dental clinics. Female dentists felt more accepting of ORHT than males (93.8% vs. 87.8%; χ2=5.145; p<0.05. 42.6% of the participants who responded thought that lack of education on ORHT for dentists was the most urgent problem to solve for ORHT, 144 (31.3% thought that lack of support for ORHT from patients was the most urgent problem. There was statistically significant difference among dental hospital, dentistry and department of dentistry (χ2=24.176; p<0.05.The majority of Chinese dentists thought that ORHT was needed in the dental setting. Providing opportunities for dentists and dental students to learn about HIV testing guidelines and practices is needed as well as feasibility and implementation science research.

Effectiveness of a peer-led HIV prevention intervention in secondary schools in Rwanda: results from a non-randomized controlled trial

Directory of Open Access Journals (Sweden)

Michielsen Kristien

2012-09-01

Full Text Available Abstract Background While the HIV epidemic is levelling off in sub-Saharan Africa, it remains at an unacceptably high level. Young people aged 15-24 years remain particularly vulnerable, resulting in a regional HIV prevalence of 1.4% in young men and 3.3% in young women. This study assesses the effectiveness of a peer-led HIV prevention intervention in secondary schools in Rwanda on young people’s sexual behavior, HIV knowledge and attitudes. Methods In a non-randomized longitudinal controlled trial, fourteen schools were selected in two neighboring districts in Rwanda Bugesera (intervention and Rwamagana (control. Students (n = 1950 in eight intervention and six control schools participated in three surveys (baseline, six and twelve months in the intervention. Analysis was done using linear and logistic regression using generalized estimation equations adjusted for propensity score. Results The overall retention rate was 72%. Time trends in sexual risk behavior (being sexually active, sex in last six months, condom use at last sex were not significantly different in students from intervention and control schools, nor was the intervention associated with increased knowledge, perceived severity or perceived susceptibility. It did significantly reduce reported stigma. Conclusions Analyzing this and other interventions, we identified several reasons for the observed limited effectiveness of peer education: 1 intervention activities (spreading information are not tuned to objectives (changing behavior; 2 young people prefer receiving HIV information from other sources than peers; 3 outcome indicators are not adequate and the context of the relationship in which sex occurs and the context in which sex occurs is ignored. Effectiveness of peer education may increase through integration in holistic interventions and redefining peer educators’ role as focal points for sensitization and referral to experts and services. Finally, we argue that a

Workplace peer educators and stress | Dickinson | African Journal of ...

African Journals Online (AJOL)

Peer educators form an important component of company responses to HIV and AIDS. Based on interviews with peer educators working in and around a mining company in South Africa's North-West Province, the study examines the relationship between involvement in peer education and stress. The paper discusses how ...

A peer adherence support intervention to improve the antiretroviral treatment outcomes of HIV patients in South Africa: the moderating role of family dynamics.

Science.gov (United States)

Wouters, Edwin; Masquillier, Caroline; Ponnet, Koen; le Roux Booysen, Frederik

2014-07-01

Given the severe shortage of human resources in the healthcare sector in many countries with high HIV prevalence, community-based peer adherence support is being increasingly cited as an integral part of a sustainable antiretroviral treatment (ART) strategy. However, the available scientific evidence on this topic reports discrepant findings on the effectiveness of peer adherence support programmes. These conflicting findings to some extent can be attributed to the lack of attention to the social contexts in which peer adherence support programmes are implemented. This study explores the potential moderating role of family dynamics by assessing the differential impact of peer adherence support in different types of families, based on the theoretical underpinnings of the family functioning framework. These relationships were explored with the aid of multivariate statistical analysis of cross-sectional, post-trial data for a sample of 340 patients interviewed as part of the Effectiveness of Aids Treatment and Support in the Free State (FEATS) study conducted in the public-sector ART programme of the Free State Province of South Africa. The analysis reveals no significant overall differences in CD4 cell count between the intervention group accessing additional peer adherence support and the control group receiving standard care. When controlling for the potential moderating role of family dynamics, however, the outcomes clearly reveal a significant interaction effect between the adherence intervention and the level of family functioning with regard to treatment outcomes. Multi-group analysis demonstrates that peer adherence support has a positive effect on immunological restoration in well-functioning families, while having a negative effect in dysfunctional families. The study outcomes stress the need for peer adherence interventions that are sensitive to the suboptimal contexts in which they are often implemented. Generic, broad-based interventions do not

HIV prevention and care services for female sex workers: efficacy of a targeted community-based intervention in Burkina Faso.

Science.gov (United States)

Traore, Isidore T; Meda, Nicolas; Hema, Noelie M; Ouedraogo, Djeneba; Some, Felicien; Some, Roselyne; Niessougou, Josiane; Sanon, Anselme; Konate, Issouf; Van De Perre, Philippe; Mayaud, Philippe; Nagot, Nicolas

2015-01-01

Although interventions to control HIV among high-risk groups such as female sex workers (FSW) are highly recommended in Africa, the contents and efficacy of these interventions are unclear. We therefore designed a comprehensive dedicated intervention targeting young FSW and assessed its impact on HIV incidence in Burkina Faso. Between September 2009 and September 2011 we conducted a prospective, interventional cohort study of FSW aged 18 to 25 years in Ouagadougou, with quarterly follow-up for a maximum of 21 months. The intervention combined prevention and care within the same setting, consisting of peer-led education sessions, psychological support, sexually transmitted infections and HIV care, general routine health care and reproductive health services. At each visit, behavioural characteristics were collected and HIV, HSV-2 and pregnancy were tested. We compared the cohort HIV incidence with a modelled expected incidence in the study population in the absence of intervention, using data collected at the same time from FSW clients. The 321 HIV-uninfected FSW enrolled in the cohort completed 409 person-years of follow-up. No participant seroconverted for HIV during the study (0/409 person-years), whereas the expected modelled number of HIV infections were 5.05/409 person-years (95% CI, 5.01-5.08) or 1.23 infections per 100 person-years (p=0.005). This null incidence was related to a reduction in the number of regular partners and regular clients, and by an increase in consistent condom use with casual clients (adjusted odds ratio (aOR)=2.19; 95% CI, 1.16-4.14, p=0.01) and with regular clients (aOR=2.18; 95% CI, 1.26-3.76, p=0.005). Combining peer-based prevention and care within the same setting markedly reduced the HIV incidence among young FSW in Burkina Faso, through reduced risky behaviours.

Estimating the cost to U.S. health departments to conduct HIV surveillance.

Science.gov (United States)

Shrestha, Ram K; Sansom, Stephanie L; Laffoon, Benjamin T; Farnham, Paul G; Shouse, R Luke; MacMaster, Karen; Hall, H Irene

2014-01-01

HIV case surveillance is a primary source of information for monitoring HIV burden in the United States and guiding the allocation of prevention and treatment funds. While the number of people living with HIV and the need for surveillance data have increased, little is known about the cost of surveillance. We estimated the economic cost to health departments of conducting high-quality HIV case surveillance. We collected primary data on the unit cost and quantity of resources used to operate the HIV case surveillance program in Michigan, where HIV burden (i.e., the number of HIV cases) is moderate to high (n=14,864 cases). Based on Michigan's data, we projected the expected annual HIV surveillance cost for U.S., state, local, and territorial health departments. We based our cost projection on the variation in the number of new and established cases, area-specific wages, and potential economies of scale. We estimated the annual total HIV surveillance cost to the Michigan health department to be $1,286,524 ($87/case), the annual total cost of new cases to be $108,657 ($133/case), and the annual total cost of established cases to be $1,177,867 ($84/case). Our projected median annual HIV surveillance cost per health department ranged from $210,600 in low-HIV burden sites to $1,835,000 in high-HIV burden sites. Our analysis shows that a systematic approach to costing HIV surveillance at the health department level is feasible. For HIV surveillance, a substantial portion of total surveillance costs is attributable to maintaining established cases.

A cluster randomized controlled trial evaluating the efficacy of peer mentors to support South African women living with HIV and their infants.

Directory of Open Access Journals (Sweden)

Mary Jane Rotheram-Borus

Full Text Available We evaluate the effect of clinic-based support by HIV-positive Peer Mentors, in addition to standard clinic care, on maternal and infant well-being among Women Living with HIV (WLH from pregnancy through the infant's first year of life.In a cluster randomized controlled trial in KwaZulu-Natal, South Africa, eight clinics were randomized for pregnant WLH to receive either: a Standard Care condition (SC; 4 clinics; n = 656 WLH; or an Enhanced Intervention (EI; 4 clinics; n = 544 WLH. WLH in the EI were invited to attend four antenatal and four postnatal meetings led by HIV-positive Peer Mentors, in addition to SC. WLH were recruited during pregnancy, and at least two post-birth assessment interviews were completed by 57% of WLH at 1.5, 6 or 12 months. EI's effect was ascertained on 19 measures of maternal and infant well-being using random effects regressions to control for clinic clustering. A binomial test for correlated outcomes evaluated EI's overall efficacy.WLH attended an average of 4.1 sessions (SD = 2.0; 13% did not attend any sessions. Significant overall benefits were found in EI compared to SC using the binomial test. Secondarily, over time, WLH in the EI reported significantly fewer depressive symptoms and fewer underweight infants than WLH in the SC condition. EI WLH were significantly more likely to use one feeding method for six months and exclusively breastfeed their infants for at least 6 months.WLH benefit by support from HIV-positive Peer Mentors, even though EI participation was partial, with incomplete follow-up rates from 6-12 months.ClinicalTrials.gov NCT00972699.

I am not "umqwayito'': a qualitative study of peer pressure and sexual risk behaviour among young adolescents in Cape Town, South Africa.

Science.gov (United States)

Selikow, Terry-Ann; Ahmed, Nazeema; Flisher, Alan J; Mathews, Catherine; Mukoma, Wanjiru

2009-06-01

Young people in South Africa are susceptible to HIV infection. They are vulnerable to peer pressure to have sex, but little is known about how peer pressure operates. The aim of the study was to understand how negative peer pressure increases high risk sexual behaviour among young adolescents in Cape Town, South Africa. Qualitative research methods were used. Eight focus groups were conducted with young people between the ages of 13 and 14 years. Peer pressure among both boys and girls undermines healthy social norms and HIV prevention messages to abstain, be faithful, use a condom and delay sexual debut. HIV prevention projects need to engage with peer pressure with the aim of changing harmful social norms into healthy norms. Increased communication with adults about sex is one way to decrease the impact of negative peer pressure. Peer education is a further mechanism by which trained peers can role model healthy social norms and challenge a peer culture that promotes high risk sexual behaviour. Successful HIV prevention interventions need to engage with the disconnect between educational messages and social messages and to exploit the gaps between awareness, decision making, norms, intentions and actions as spaces for positive interventions.

The community-based participatory intervention effect of "HIV-RAAP".

Science.gov (United States)

Yancey, Elleen M; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H; Yuan, Keming

2012-07-01

To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission.

Greater involvement of HIV-infected peer-mothers in provision of reproductive health services as "family planning champions" increases referrals and uptake of family planning among HIV-infected mothers.

Science.gov (United States)

Mudiope, Peter; Musingye, Ezra; Makumbi, Carolyne Onyango; Bagenda, Danstan; Homsy, Jaco; Nakitende, Mai; Mubiru, Mike; Mosha, Linda Barlow; Kagawa, Mike; Namukwaya, Zikulah; Fowler, Mary Glenn

2017-06-27

In 2012, Makerere University Johns - Hopkins University, and Mulago National Referral Hospital, with support from the National Institute of Health (under Grant number: NOT AI-01-023) undertook operational research at Mulago National Hospital PMTCT/PNC clinics. The study employed Peer Family Planning Champions to offer health education, counselling, and triage aimed at increasing the identification, referral and family planning (FP) uptake among HIV positive mothers attending the clinic. The Peer Champion Intervention to improve FP uptake was introduced into Mulago Hospital PMTCT/PNC clinic, Kampala Uganda. During the intervention period, peers provided additional FP counselling and education; assisted in identification and referral of HIV Positive mothers in need of FP services; and accompanied referred mothers to FP clinics. We compiled and compared the average proportions of mothers in need that were referred and took up FP in the pre-intervention (3 months), intervention (6 months), and post-intervention(3 months) periods using interrupted time series with segmented regression models with an autoregressive term of one. Overall, during the intervention, the proportion of referred mothers in need of FP increased by 30.4 percentage points (P family planning can be a valuable addition to clinic staff in limited-resource settings. The study provides additional evidence on the utilization of peer mothers in HIV care, improves health services uptake including family planning which is a common practice in many donor supported programs. It also provides evidence that may be used to advocate for policy revisions in low-income countries to include peers as support staff especially in busy clinic settings with poor services uptake.

Safer disclosure of HIV serostatus for women living with HIV who experience or fear violence: a systematic review.

Science.gov (United States)

Kennedy, Caitlin E; Haberlen, Sabina; Amin, Avni; Baggaley, Rachel; Narasimhan, Manjulaa

2015-01-01

Supporting individuals as they disclose their HIV serostatus may lead to a variety of individual and public health benefits. However, many women living with HIV are hesitant to disclose their HIV status due to fear of negative outcomes such as violence, abandonment, relationship dissolution and stigma. We conducted a systematic review of studies evaluating interventions to facilitate safer disclosure of HIV status for women living with HIV who experience or fear violence. Articles, conference abstracts and programme reports were included if they reported post-intervention evaluation results and were published before 1 April 2015. Searching was conducted through electronic databases for peer-reviewed articles and conference abstracts, reviewing websites of relevant organizations for grey literature, hand searching reference lists of included studies and contacting experts. Systematic methods were used for screening and data abstraction, which was conducted in duplicate. Study quality (rigor) was assessed with the Cochrane risk of bias tool. Two interventions met the inclusion criteria: the Safe Homes and Respect for Everyone cluster-randomized trial of combination HIV and intimate partner violence (IPV) services in Rakai, Uganda, and the South Africa HIV/AIDS Antenatal Post-Test Support study individual randomized trial of an enhanced counselling intervention for pregnant women undergoing HIV testing and counselling. Both programmes integrated screening for IPV into HIV testing services and trained counsellors to facilitate discussions about disclosure based on a woman's risk of violence. However, both were implemented as part of multiple-component interventions, making it impossible to isolate the impact of the safer disclosure components. The existing evidence base for interventions to facilitate safe HIV serostatus disclosure for women who experience or fear violence is limited. Development and implementation of new approaches and rigorous evaluation of safe

Sweating under pressure: skin conductance level reactivity moderates the association between peer victimization and externalizing behavior.

Science.gov (United States)

Gregson, Kim D; Tu, Kelly M; Erath, Stephen A

2014-01-01

This study examined whether the association between peer victimization and externalizing behavior may be illuminated by individual differences in skin conductance level reactivity (SCLR) in the context of peer stress. Participants included 123 fifth and sixth graders (Mean age = 12.03 years, 50% females; 42% ethnic minorities). SCLR was assessed in the context of an ecologically relevant, lab-based peer-evaluative stress experience in preadolescence. As hypothesized, self-reported peer victimization was linked with parent- and teacher-reported externalizing behavior, and SCLR consistently moderated these associations. Peer victimization was associated with parent- and teacher-reported externalizing behavior among preadolescents who exhibited lower SCLR, but not among preadolescents who exhibited higher SCLR. Results suggest that promoting engagement with peer stress experiences and enhancing inhibitory control are potential intervention targets that may reduce externalizing behavior in the context of peer victimization (or reduce peer victimization among preadolescents who exhibit externalizing behavior). © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

Participants as community-based peer educators: Impact on a clinical trial site in KwaZulu-Natal

Directory of Open Access Journals (Sweden)

Sarita Naidoo

2013-07-01

Full Text Available Participant recruitment, retention and product adherence are necessary to measure the efficacy or effectiveness of an intervention in a clinical trial. As part of a Phase III HIV prevention trial in a rural area in Kwazulu-Natal, South Africa, a peer educator programme was initiated to aid in recruitment and retention of trial participants from the community. Enrolled trial participants who had completed at least 6 months of trial participation and who had honoured all of their scheduled trial visits within that period were approached to be peer educators. Following additional selection criteria, 24 participants were eligible to be trained as peer educators. Training topics included HIV/AIDS, sexually transmitted infections, nutrition, antiretrovirals, clinical trials, and methods of disseminating this information to the community. The role of peer educators was to bring interested women from their community to the trial site for comprehensive education and information about the trial and possibly trial participation. A total of 1879 women were educated by peer educators between July 2004 and December 2006. Of these, 553 women visited the trial site for further education and screening for participation in the trial. Peer educators provided continuous education and support to women enrolled in the trial which also promoted retention, ultimately contributing to the site's 94% retention rate. Recruitment and retention efforts of trial participants are likely to be enhanced by involving trial participants as peer educators. Such trial participants are in a better position to understand cultural dynamics and hence capable of engaging the community with appropriate HIV prevention and trial-related messaging.

Impact of community-based interventions on HIV knowledge, attitudes, and transmission.

Science.gov (United States)

Salam, Rehana A; Haroon, Sarah; Ahmed, Hashim H; Das, Jai K; Bhutta, Zulfiqar A

2014-01-01

In 2012, an estimated 35.3 million people lived with HIV, while approximately two million new HIV infections were reported. Community-based interventions (CBIs) for the prevention and control of HIV allow increased access and ease availability of medical care to population at risk, or already infected with, HIV. This paper evaluates the impact of CBIs on HIV knowledge, attitudes, and transmission. We included 39 studies on educational activities, counseling sessions, home visits, mentoring, women's groups, peer leadership, and street outreach activities in community settings that aimed to increase awareness on HIV/AIDS risk factors and ensure treatment adherence. Our review findings suggest that CBIs to increase HIV awareness and risk reduction are effective in improving knowledge, attitudes, and practice outcomes as evidenced by the increased knowledge scores for HIV/AIDS (SMD: 0.66, 95% CI: 0.25, 1.07), protected sexual encounters (RR: 1.19, 95% CI: 1.13, 1.25), condom use (SMD: 0.96, 95% CI: 0.03, 1.58), and decreased frequency of sexual intercourse (RR: 0.76, 95% CI: 0.61, 0.96). Analysis shows that CBIs did not have any significant impact on scores for self-efficacy and communication. We found very limited evidence on community-based management for HIV infected population and prevention of mother- to-child transmission (MTCT) for HIV-infected pregnant women. Qualitative synthesis suggests that establishment of community support at the onset of HIV prevention programs leads to community acceptance and engagement. School-based delivery of HIV prevention education and contraceptive distribution have also been advocated as potential strategies to target high-risk youth group. Future studies should focus on evaluating the effectiveness of community delivery platforms for prevention of MTCT, and various emerging models of care to improve morbidity and mortality outcomes.

Effects of an HIV peer prevention intervention on sexual and injecting risk behaviors among injecting drug users and their risk partners in Thai Nguyen, Vietnam: a randomized controlled trial.

Science.gov (United States)

Go, Vivian F; Frangakis, Constantine; Le Minh, Nguyen; Latkin, Carl A; Ha, Tran Viet; Mo, Tran Thi; Sripaipan, Teerada; Davis, Wendy; Zelaya, Carla; Vu, Pham The; Chen, Yong; Celentano, David D; Quan, Vu Minh

2013-11-01

Globally, 30% of new HIV infections outside sub-Saharan Africa involve injecting drug users (IDU) and in many countries, including Vietnam, HIV epidemics are concentrated among IDU. We conducted a randomized controlled trial in Thai Nguyen, Vietnam, to evaluate whether a peer oriented behavioral intervention could reduce injecting and sexual HIV risk behaviors among IDU and their network members. 419 HIV-negative index IDU aged 18 years or older and 516 injecting and sexual network members were enrolled. Each index participant was randomly assigned to receive a series of six small group peer educator-training sessions and three booster sessions in addition to HIV testing and counseling (HTC) (intervention; n = 210) or HTC only (control; n = 209). Follow-up, including HTC, was conducted at 3, 6, 9 and 12 months post-intervention. The proportion of unprotected sex dropped significantly from 49% to 27% (SE (difference) = 3%, p < 0.01) between baseline and the 3-month visit among all index-network member pairs. However, at 12 months, post-intervention, intervention participants had a 14% greater decline in unprotected sex relative to control participants (Wald test = 10.8, df = 4, p = 0.03). This intervention effect is explained by trial participants assigned to the control arm who missed at least one standardized HTC session during follow-up and subsequently reported increased unprotected sex. The proportion of observed needle/syringe sharing dropped significantly between baseline and the 3-month visit (14% vs. 3%, SE (difference) = 2%, p < 0.01) and persisted until 12 months, but there was no difference across trial arms (Wald test = 3.74, df = 3, p = 0.44). Copyright © 2013 Elsevier Ltd. All rights reserved.

A Peer-Educator Network HIV Prevention Intervention Among Injection Drug Users: Results of a Randomized Controlled Trial in St. Petersburg, Russia

Science.gov (United States)

Latkin, Carl A.; Kukhareva, Polina V.; Malov, Sergey V.; Batluk, Julia V.; Shaboltas, Alla V.; Skochilov, Roman V.; Sokolov, Nicolay V.; Verevochkin, Sergei V.; Hudgens, Michael G.; Kozlov, Andrei P.

2014-01-01

We evaluated the efficacy of a peer-educator network intervention as a strategy to reduce HIV acquisition among injection drug users (IDUs) and their drug and/or sexual networks. A randomized controlled trial was conducted in St. Petersburg, Russia among IDU index participants and their risk network participants. Network units were randomized to the control or experimental intervention. Only the experimental index participants received training sessions to communicate risk reduction techniques to their network members. Analysis includes 76 index and 84 network participants who were HIV uninfected. The main outcome measure was HIV sero-conversion. The incidence rates in the control and experimental groups were 19.57 (95 % CI 10.74–35.65) and 7.76 (95 % CI 3.51–17.19) cases per 100 p/y, respectively. The IRR was 0.41 (95 % CI 0.15–1.08) without a statistically significant difference between the two groups (log rank test statistic X2 = 2.73, permutation p value = 0.16). Retention rate was 67 % with a third of the loss due to incarceration or death. The results show a promising trend that this strategy would be successful in reducing the acquisition of HIV among IDUs. PMID:23881187

The Community-based Participatory Intervention Effect of “HIV-RAAP”

Science.gov (United States)

Yancey, Elleen M.; Mayberry, Robert; Armstrong-Mensah, Elizabeth; Collins, David; Goodin, Lisa; Cureton, Shava; Trammell, Ella H.; Yuan, Keming

2012-01-01

Objectives To design and test HIV-RAAP (HIV/AIDS Risk Reduction Among Heterosexually Active African American Men and Women: A Risk Reduction Prevention Intervention) a coeducational, culture- and gender-sensitive community-based participatory HIV risk reduction intervention. Methods A community-based participatory research process included intervention development and implementation of a 7-session coeducational curriculum conducted over 7 consecutive weeks. Results The results indicated a significant intervention effect on reducing sexual behavior risk (P=0.02), improving HIV risk knowledge (P=0.006), and increasing sexual partner conversations about HIV risk reduction (P= 0.001). Conclusions The HIV-RAAP intervention impacts key domains of heterosexual HIV transmission. PMID:22488405

Friends, Sisters, and Wives: Social Support and Social Risks in Peer Relationships Among Men Who Have Sex With Men (MSM) in India.

Science.gov (United States)

Tomori, Cecilia; Srikrishnan, Aylur K; Ridgeway, Kathleen; Solomon, Sunil S; Mehta, Shruti H; Solomon, Suniti; Celentano, David D

2016-04-01

Globally, men who have sex with men (MSM) are at high risk for HIV. Many HIV-prevention efforts rely on community outreach and mobilization to engage MSM. This study examines peer relationships and their potential role in HIV prevention through 31 focus group discussions (FGDS) and 121 in-depth interviews (IDIs) with 363 MSM across 15 sites in India. Results indicate that MSM receive social support in friendships, sex-worker collaborations, constructed kin relationships, and romantic partnerships. Access to these relationships, however, is uneven across MSM, and can carry risks of disclosure of same-sex behavior and exclusion based on HIV- positive status. Positive peer relationships can serve as the basis of community empowerment, education, and couple-based interventions for MSM, and peer counselors can also provide a buffer against the social risks of peer relationships and facilitate linkage to care and continued engagement in treatment. These insights can improve HIV interventions for MSM in India and elsewhere.

Bereavement, silence and culture within a peer-led HIV/AIDS-prevention strategy for vulnerable children in South Africa.

Science.gov (United States)

Van der Heijden, Ingrid; Swartz, Sharlene

2010-04-01

In addressing the psychosocial effects of the HIV and AIDS pandemic among vulnerable children, the issue of bereavement appears inadequately addressed. Amid the global discourse on children orphaned and made vulnerable by HIV and AIDS, this paper explores how cultural contexts and social environments in South Africa shape children's experience of grief. The argument draws on a number of qualitative studies and uses empirical evidence from an evaluation of a peer-led HIV/AIDS-prevention strategy aimed at providing psychosocial support for 10- to 13-year-old South African children living in resource-poor communities. The paper reveals a central paradox regarding how the intervention's objective of talking about death and eliciting memories of deceased loved ones with young children is confounded by cultural practices located in notions of silence and the need to protect children. The paper acknowledges the 'culture of silence' surrounding death in some African contexts, but concludes that peer-led strategies have the potential to naturally circumvent these cultural taboos, simultaneously creating a much-needed space for young children to cry and talk among themselves, even if remaining silent at home in the presence of adults.

HIV prevention in Latin America: reaching youth in Colombia.

Science.gov (United States)

Perez, F; Dabis, F

2003-02-01

The aim of this paper is to describe and evaluate a school-based peer education programme on HIV primary prevention implemented in urban marginal districts of three cities of Colombia from 1997 to 1999. Its main objective was to promote risk awareness and safe sexual behaviours among urban youth populations. Methodology included the collection of baseline information through qualitative methods (focus groups and in-depth interviews), a knowledge, attitudes and practices (KAP) survey, a health education intervention, and post-intervention data collection. Direct beneficiaries were adolescents 10 to 19 years of age, and secondary school teachers of 6th to 9th grades. Main strategies used were peer education and classroom sessions conducted by trained teachers. Short-term results suggest that the programme had a positive effect on knowledge and attitudes related to HIV/AIDS (as the mean knowledge summary indicator among adolescents and secondary school teachers increased 24% and 21%, respectively). The main outcome has been the development of a sex education programme, emphasizing the role of schools in the promotion of sexual and reproductive health. Mass education by a combination of interventions and events at school level, backed up by effective interpersonal communication such as peer education, classroom teaching and community actions are effective primary prevention strategies for HIV sexual transmission and should be more extensively considered.

HIV prevention among street-based sex workers (SSWs) in Chongqing, China: interviews with SSWs, clients and healthcare providers.

Science.gov (United States)

Zeng, Huan; Zhang, Lei; Zhao, Yong; Liu, Hui; Guo, Hang; Wang, Yang; Zhang, Zhen; Mao, Limin

2016-11-01

Street-based female sex workers (SSWs) are subjected to a relatively high risk of HIV transmission, even higher than establishment-based female sex workers in China. However, very few HIV intervention programmes have targeted this particular group to date. Based in Southwest China, this study aims to identify perceived barriers, demands and suggestions on HIV prevention from the perspectives of SSWs, clients and healthcare providers in Chongqing. Face-to-face, in-depth interviews were conducted in July 2008 with 23 participants. They were recruited by purposive, convenience sampling and included 12 SSWs, 5 male clients, 4 government healthcare providers and 2 outreach workers from a community-based non-governmental organisation. Thematic analysis was used. SSWs were largely rural-to-urban migrants with a low socioeconomic status. Most of their clients shared a similar background. Both SSWs and their clients demonstrated a low awareness of HIV infection and a lack of understanding of effective preventive strategies. Financial hardships, lack of family support, fear of police arrest and stigma in relation to sex work were identified as SSWs' major barriers for accessing healthcare services. Both SSWs and their clients indicated an urgent demand for accessing adequate HIV prevention and care programmes. On the other hand, government organisations trying to provide services to this group have also encountered obstacles, specifically their limited ability to establish mutual trust. Programmes provided by community-based non-governmental organisation, however, were perceived to be more attractive. In conclusion, there remains a substantial gap between the need of adequate HIV prevention services for SSWs and their clients and what is currently available. Strengthening inter-sectoral collaboration, providing specifically tailored health services, actively involving SSW peers and their clients, and reducing stigma in the society are keys to meet this urgent demand by SSWs

Factors influencing social self-disclosure among adolescents living with HIV in Eastern Africa.

Science.gov (United States)

Nöstlinger, Christiana; Bakeera-Kitaka, Sabrina; Buyze, Jozefien; Loos, Jasna; Buvé, Anne

2015-01-01

Adolescents living with HIV (ALHIV) face many psychosocial challenges, including HIV disclosure to others. Given the importance of socialization during the adolescent transition process, this study investigated the psychological and social factors influencing self-disclosure of own HIV status to peers. We examined social HIV self-disclosure to peers, and its relationship to perceived HIV-related stigma, self-efficacy to disclose, self-esteem, and social support among a sample of n = 582 ALHIV aged 13-17 years in Kampala, Uganda, and Western Kenya. Data were collected between February and April 2011. Among them, 39% were double orphans. We conducted a secondary data analysis to assess the degree of social disclosure, reactions received, and influencing factors. Interviewer-administered questionnaires assessed medical, socio-demographic, and psychological variables (Rosenberg self-esteem scale; self-efficacy to disclose to peers), HIV-related stigma (10-item stigma scale), and social support (family-life and friends). Descriptive, bivariate, and logistic regression analyses were performed with social self-disclosure to peers with gender as covariates. Almost half of ALHIV had told nobody (except health-care providers) about their HIV status, and about 18% had disclosed to either one of their friends, schoolmates, or a boy- or girlfriend. Logistic regression models revealed that having disclosed to peers was significantly related to being older, being a paternal orphan, contributing to family income, regular visits to the HIV clinic, and greater social support through peers. Low self-efficacy to disclose was negatively associated to the outcome variable. While social self-disclosure was linked to individual factors such as self-efficacy, factors relating to the social context and adolescents' access to psychosocial resources play an important role. ALHIV need safe environments to practice disclosure skills. Interventions should enable them to make optimal use of

HIV incidence in sub-Saharan Africa: a review of available data with implications for surveillance and prevention planning

NARCIS (Netherlands)

Braunstein, Sarah L.; van de Wijgert, Janneke H. H. M.; Nash, Denis

2009-01-01

HIV incidence estimation is increasingly being incorporated into HIV/AIDS surveillance activities in both resource-rich and developing countries. We conducted a systematic review to assess the availability of HIV incidence data from sub-Saharan Africa. We examined peer-reviewed articles, conference

Paper-pen peer-correction versus wiki-based peer-correction

Directory of Open Access Journals (Sweden)

Froldova Vladimira

2016-01-01

Full Text Available This study reports on the comparison of the students’ achievement and their attitudes towards the use of paper-pen peer-correction and wiki-based peer-correction within English language lessons and CLIL Social Science lessons at the higher secondary school in Prague. Questionnaires and semi-structured interviews were utilized to gather information. The data suggests that students made considerable use of wikis and showed higher degrees of motivation in wiki-based peer-correction during English language lessons than in CLIL Social Science lessons. In both cases wikis not only contributed to developing students’ writing skills, but also helped students recognize the importance of collaboration.

Effectiveness of peer-led education on knowledge, attitude and risk behavior practices related to HIV among students at a Malaysian public university--a randomized controlled trial.

Science.gov (United States)

Ibrahim, Normala; Rampal, Lekhraj; Jamil, Zubaidah; Zain, Azhar Mohd

2012-11-01

Develop, implement and evaluate the effectiveness of a peer-led education program related to HIV/AIDS among university students. randomized controlled trial with 276 university students at Faculty of Medicine and Health Sciences University Putra Malaysia (UPM), Serdang in 2011. A peer-led education program on HIV prevention by university students. differences in knowledge, attitude and risk behavior practices related to HIV between baselines, immediate follow-up after intervention and after three months. Significant improvement in sound knowledge in the intervention group as compared to the control group (Odds ratio, 1.75; 95% CI 1.01, 3.00; p=0.04) and improvement in good attitude related to HIV (Odds ratio 2.22; 95% CI 1.37, 3.61; p=0.01). The odds of high substance risk behavior was significantly reduced in the intervention group as compared to the control group (Odds ratio 0.07; 95% CI 0.02, 0.34; p=0.01). The association between good knowledge and intervention was modified by the different time points (baseline, immediately after intervention and 3 months after intervention), ethnicity and gender. Peer-led education program in HIV prevention improves knowledge, attitude and substance risk behavior. Changes in sexual risk behavior may require a longer follow-up. Copyright © 2012 Elsevier Inc. All rights reserved.

Intersectionality of HIV stigma and masculinity in eastern Uganda: implications for involving men in HIV programmes.

Science.gov (United States)

Mburu, Gitau; Ram, Mala; Siu, Godfrey; Bitira, David; Skovdal, Morten; Holland, Paula

2014-10-11

Stigma is a determinant of social and health inequalities. In addition, some notions of masculinity can disadvantage men in terms of health outcomes. However, few studies have explored the extent to which these two axes of social inequality intersect to influence men's health outcomes. This paper investigates the intersection of HIV stigma and masculinity, and its perceived impact on men's participation in and utilisation of HIV services in Uganda. Interviews and focus group discussions were conducted in Mbale and Jinja districts of Uganda between June and October 2010. Participants were men and women living with HIV (n = 40), their family members (n = 10) and health providers (n = 15). Inductive analysis was used to identify mechanisms through which stigma and masculinity were linked. Our findings showed that HIV stigma and masculinity did not exist as isolated variables, but as intersecting phenomena that influenced men's participation in HIV services. Specifically, HIV stigma threatened masculine notions of respectability, independence and emotional control, while it amplified men's risk-taking. As a result, the intersection of masculinity and HIV stigma prevented some men from i) seeking health care and accepting a 'sick role'; ii) fulfilling their economic family responsibilities; iii) safeguarding their reputation and respectability; iv) disclosing their HIV status; and v) participating in peer support groups. Participation in some peer support activities was considered a female trait and it also exacerbated HIV stigma as it implicitly singled out those with HIV. In contrast, inclusion of income-generating activities in peer support groups encouraged men's involvement as it enabled them to provide for their families, cushioned them from HIV stigma, and in the process, provided them with an opportunity to redeem their reputation and respectability. To improve men's involvement in HIV services, the intersection between HIV stigma and masculinity should be

Sex, condoms, gender roles, and HIV transmission knowledge among adolescents in León, Nicaragua: implications for HIV prevention.

Science.gov (United States)

Manji, A; Peña, R; Dubrow, R

2007-09-01

There are few peer-reviewed studies of HIV/AIDS-related knowledge, attitudes, beliefs and practices among adolescents in Central America. A population-based cross-sectional survey was conducted among 246 adolescents in León, Nicaragua, where there is reason for concern about a rise in HIV infections. In many respects, León adolescents were typical of those in other Latin American countries, with a mixture of correct and incorrect knowledge about transmission of HIV and sexually transmitted infections, a higher proportion of males than females reporting having had sex or using condoms, and inconsistent condom use. While some sexual attitudes conformed to the ideology of machismo, others did not, providing an opening for prevention interventions. Some dimensions of HIV/AIDS stigma were high, and most adolescents disapproved of same-sex sexual behaviour. Intervention against homosexuality-related stigma is particularly urgent because a concentrated HIV epidemic may be emerging in Nicaragua among men who have sex with men. Personal religious beliefs did not appear to pose a barrier to condom use. In a multivariate model, being out of school was a significant correlate of having had sex and of insufficient HIV/AIDS-related knowledge. Accordingly, HIV prevention interventions must reach adolescents both in and out of school. A multi-component approach to prevention is needed, including programmes based in schools, communities, the mass media and health facilities.

Expertise-based peer selection in Peer-to-Peer networks

NARCIS (Netherlands)

Haase, Peter; Siebes, Ronny; Harmelen, van Frank

2007-01-01

Peer-to-Peer systems have proven to be an effective way of sharing data. Modern protocols are able to efficiently route a message to a given peer. However, determining the destination peer in the first place is not always trivial. We propose a model in which peers advertise their expertise in

Expertise-based peer selection in Peer-to-Peer networks

NARCIS (Netherlands)

Haase, Peter; Siebes, Ronny; Harmelen, van Frank

2007-01-01

Peer-to-Peer systems have proven to be an effective way of sharing data. Modern protocols are able to efficiently route a message to a given peer. However, determining the destination peer in the first place is not always trivial. We propose a a message to a given peer. However, determining the

How best can we plan & implement HIV prevention? A review of successful evidence based practices & research

Directory of Open Access Journals (Sweden)

Vijay Kumar Chattu

2014-07-01

Full Text Available Context: Around 2.5 million people become infected with HIV each year and its impact on human life and public health can only be tackled and reversed only by sound prevention strategies. Aim: This paper aims to provide the reader about different types of prevention strategies that are effective and practiced in various countries with special emphasis on evidence for success. It also highlights the importance of to the evidence based medicine& strategies. It describes about the importance of combination prevention, which encompasses complementary behavioral, biomedical and structural prevention strategies. Methods & Materials: Searches for peer reviewed journal articles was conducted using the search engines to gather the information from databases of medicine, health sciences and social sciences. Information for each strategy is organized & presented systematically with detailed discussion. Results: For a successful reduction in HIV transmission, there is a great need for combined effects of radical & sustainable behavioral changes among individuals who are potentially at risk. Second, combination prevention is essential for HIV prevention is neither simple nor simplistic. Reductions in HIV transmission need widespread and sustained efforts. A mix of communication channels are essential to disseminate messages to motivate people to engage in various methods of risk reduction. Conclusions: The effect of behavioral strategies could be increased by aiming for many goals that are achieved by use of multilevel approaches with populations both uninfected and infected with HIV. Combination prevention programs operate on different levels to address the specific, but diverse needs of the populations at risk of HIV infection.

The multidimensional nature of HIV stigma: evidence from Mozambique.

Science.gov (United States)

Carrasco, Maria A; Arias, Rosario; Figueroa, Maria E

2017-03-01

HIV stigma continues to be a major challenge to addressing HIV/AIDS in various countries in sub-Saharan Africa, including Mozambique. This paper explores the multidimensional nature of HIV stigma through the thematic analysis of five qualitative studies conducted in high HIV prevalence provinces in Mozambique between 2009 and 2012. These studies included 23 interviews with people living with HIV (PLHIV) (10 women and 13 men); 6 focus groups with 32 peer educators (24 women and 8 men) working for community-based organisations (CBOs) providing services to PLHIV; 17 focus groups with community members (72 men and 70 women); 6 interviews (4 women and 2 men) with people who had family members living with HIV/AIDS; 24 focus groups (12 with men and 12 with women) and 6 interviews with couples. Our findings indicate that HIV stigma is a barrier to HIV testing and counselling, status disclosure, partner notification, and antiretroviral therapy (ART) access and adherence, and that moral stigma seems to be more common than physical stigma. Additionally, the findings highlight that HIV stigma is a dynamic social process that is conceptualised as being tied to personal responsibility. To effectively diminish HIV stigma in Mozambique, future interventions should address moral stigma and re-conceptualise HIV as a chronic disease.

Leveraging social capital: multilevel stigma, associated HIV vulnerabilities, and social resilience strategies among transgender women in Lima, Peru.

Science.gov (United States)

Perez-Brumer, Amaya G; Reisner, Sari L; McLean, Sarah A; Silva-Santisteban, Alfonso; Huerta, Leyla; Mayer, Kenneth H; Sanchez, Jorge; Clark, Jesse L; Mimiaga, Matthew J; Lama, Javier R

2017-02-28

In Peru, transgender women (TW) experience unique vulnerabilities for HIV infection due to factors that limit access to, and quality of, HIV prevention, treatment and care services. Yet, despite recent advances in understanding factors associated with HIV vulnerability among TW globally, limited scholarship has examined how Peruvian TW cope with this reality and how existing community-level resilience strategies are enacted despite pervasive social and economic exclusion facing the community. Addressing this need, our study applies the understanding of social capital as a social determinant of health and examines its relationship to HIV vulnerabilities to TW in Peru. Using qualitative methodology to provide an in-depth portrait, we assessed (1) intersections between social marginalization, social capital and HIV vulnerabilities; and (2) community-level resilience strategies employed by TW to buffer against social marginalization and to link to needed HIV-related services in Peru. Between January and February 2015, 48 TW participated (mean age = 29, range = 18-44) in this study that included focus group discussions and demographic surveys. Analyses were guided by an immersion crystallization approach and all coding was conducted using Dedoose Version 6.1.18. Themes associated with HIV vulnerability included experiences of multilevel stigma and limited occupational opportunities that placed TW at risk for, and limited their engagement with, existing HIV services. Emergent resiliency-based strategies included peer-to-peer and intergenerational knowledge sharing, supportive clinical services (e.g. group-based clinic attendance) and emotional support through social cohesion (i.e. feeling part of a community). This study highlights the importance of TW communities as support structures that create and deploy social resiliency-based strategies aimed at deterring and mitigating the impact of social vulnerabilities to discrimination, marginalization and HIV risk for

Gender and Conduct Problems Predict Peer Functioning among Children with Attention-Deficit/Hyperactivity Disorder

Science.gov (United States)

Mikami, Amori Yee; Lorenzi, Jill

2011-01-01

Children with attention-deficit/hyperactivity disorder (ADHD) often have poor relationships with peers. However, research on this topic has predominantly focused on boys. This study considered child gender, ADHD status, and dimensionally assessed conduct problems as predictors of peer relationship difficulties. Participants were 125 children (ages…

Men who have sex with men in Southeastern Europe: Underground and at increased risk for HIV/STIs.

Science.gov (United States)

Longfield, Kim; Astatke, Hibist; Smith, Reid; McPeak, Georgia; Ayers, Jim

2007-01-01

This paper reports on research that aimed to identify risk factors and preventive behaviours for HIV/STIs among men who have sex with men in Bulgaria, Kosovo, Macedonia and Romania. Twelve peer researchers conducted interviews on sexual behaviour, condom use and HIV/STI awareness. Data analysis revealed common themes across countries. Sexual activity takes place both in public spaces and private homes. Many men believe that careful partner selection and closing sexual networks to outsiders mitigate risk. Risk behaviours include unprotected sex within multiple partnerships, inconsistent condom use and the use of oil-based lubricants that compromise the integrity of condoms. Perceived susceptibility for infection is low and misconceptions exist about modes of transmission. Stigma and discrimination force men into clandestine settings and relationships where safer sexual behaviour is difficult. HIV prevention programmes should convey messages through the internet and peer networks, improve access to condoms and water-based lubricant, raise awareness about STIs, link men who have sex with men to appropriate services and reduce stigma to enable safer behaviour.

HIV+ and HIV- youth living in group homes in South Africa need more psychosocial support.

Science.gov (United States)

Nestadt, D F; Alicea, S; Petersen, I; John, S; Myeza, N P; Nicholas, S W; Cohen, L G; Holst, H; Bhana, A; McKay, M M; Abrams, E J; Mellins, C A

2013-07-01

Orphans and vulnerable youth who live in group homes are at risk of poor mental health and sexual and drug-using behaviors that increase the risk of HIV transmission. This study explores factors related to this risk among youth living in group homes ("children's homes") for orphans and vulnerable children in South Africa, a country afflicted by high levels of parental loss due to HIV. The study explores 1) knowledge and attitudes about HIV, 2) social support, 3) communication with group home caregivers, and 4) the relevance of an existing evidence-based HIV prevention and mental health promotion program to situations where sexual and drug risk behaviors can occur. In-depth qualitative individual interviews were conducted with 20 youth (age 10 to 16 years) residing in two children's homes in Durban, South Africa. Content analysis focused on critical themes related to coping and prevention of risk activities. Respondents exhibited inconsistent and incomplete knowledge of HIV transmission and prevention. They displayed positive attitudes toward people living with HIV, but reported experiencing or witnessing HIV-related stigma. Participants witnessed substance use and romantic/sexual relationships among their peers; few admitted to their own involvement. While relationships with childcare workers were central to their lives, youth reported communication barriers related to substance use, sex, HIV, and personal history (including parental loss, abuse, and other trauma). In conclusion, these qualitative data suggest that evidence-based HIV prevention programs that bring caregivers and youth together to improve communication, HIV knowledge, social support, youth self-esteem, and health care, reduce sexual and drug risk behaviors, and strengthen skills related to negotiating situations of sexual and substance use possibility could benefit youth and childcare workers in children's homes.

Community-Based Research among Marginalized HIV Populations: Issues of Support, Resources, and Empowerment

Directory of Open Access Journals (Sweden)

Mario Brondani

2012-01-01

Full Text Available A research question was posed to us by a local HIV-resource organization interested in exploring the educational and service needs of those unreached. In order to properly address this inquiry, we developed a community-based participatory research by training peer-led volunteers to facilitate focus-group discussions within Aboriginal and refugees participants following an interview guide. We gathered Aboriginal people and refugees separated into three focus groups each, enrolling a total of 41 self-identified HIV-positive, 38 males. The discussions were tape recorded upon consent and lasted between 59 and 118 minutes. We analyzed the thematic information collected interactively through constant comparison. The qualitative data leading to categories, codes, and themes formed the basis for the spatial representation of a conceptual mapping. Both groups shared similar struggles in living with HIV and in properly accessing local nonmedical HIV resources and discussed their concerns towards the need for empowerment and support to take control of their health.

HIV provider and patient perspectives on the Development of a Health Department "Data to Care" Program: a qualitative study.

Science.gov (United States)

Dombrowski, Julia C; Carey, James W; Pitts, Nicole; Craw, Jason; Freeman, Arin; Golden, Matthew R; Bertolli, Jeanne

2016-06-10

U.S. health departments have not historically used HIV surveillance data for disease control interventions with individuals, but advances in HIV treatment and surveillance are changing public health practice. Many U.S. health departments are in the early stages of implementing "Data to Care" programs to assists persons living with HIV (PLWH) with engaging in care, based on information collected for HIV surveillance. Stakeholder engagement is a critical first step for development of these programs. In Seattle-King County, Washington, the health department conducted interviews with HIV medical care providers and PLWH to inform its Data to Care program. This paper describes the key themes of these interviews and traces the evolution of the resulting program. Disease intervention specialists conducted individual, semi-structured qualitative interviews with 20 PLWH randomly selected from HIV surveillance who had HIV RNA levels >10,000 copies/mL in 2009-2010. A physician investigator conducted key informant interviews with 15 HIV medical care providers. Investigators analyzed de-identified interview transcripts, developed a codebook of themes, independently coded the interviews, and identified codes used most frequently as well as illustrative quotes for these key themes. We also trace the evolution of the program from 2010 to 2015. PLWH generally accepted the idea of the health department helping PLWH engage in care, and described how hearing about the treatment experiences of HIV seropositive peers would assist them with engagement in care. Although many physicians were supportive of the Data to Care concept, others expressed concern about potential health department intrusion on patient privacy and the patient-physician relationship. Providers emphasized the need for the health department to coordinate with existing efforts to improve patient engagement. As a result of the interviews, the Data to Care program in Seattle-King County was designed to incorporate an HIV

Amphetamine-type stimulants and HIV infection among men who have sex with men: implications on HIV research and prevention from a systematic review and meta-analysis

OpenAIRE

Nga Thi Thu Vu; Lisa Maher; Iryna Zablotska

2015-01-01

Introduction: HIV infections and the use of amphetamine-type stimulants (ATS) among men who have sex with men (MSM) have been increasing internationally, but the role of ATS use as a co-factor for HIV infection remains unclear. We aimed to summarize the association between ATS use and HIV infection among MSM. Methods: We conducted a systematic search of MEDLINE, EMBASE, GLOBAL HEALTH and PsycINFO for relevant English, peer-reviewed articles of quantitative studies published between 1980 and 2...

Peer counselling versus standard-of-care on reducing high-risk behaviours among newly diagnosed HIV-positive men who have sex with men in Beijing, China: a randomized intervention study.

Science.gov (United States)

Liu, Yu; Vermund, Sten H; Ruan, Yuhua; Liu, Hongjie; Rivet Amico, K; Simoni, Jane M; Shepherd, Bryan E; Shao, Yiming; Qian, Han-Zhu

2018-02-01

Reducing high-risk behaviours (i.e. multiple partnership, condomless anal/vaginal sex, alcohol use before sex, illicit drug use) after HIV diagnosis is critical for curtailing HIV transmission. We designed an intervention to explore peer- counselling in reducing high-risk behaviours among newly diagnosed HIV-positive Chinese men who have sex with men (MSM). We randomized 367 newly diagnosed HIV-positive men to either standard-of-care (SOC; n = 183) or peer-counselling intervention (n = 184), and followed them for 12 months (visit at 0-, 3-, 6-, 9- and 12-month). SOC participants received counselling on high-risk behaviour reduction by clinic staff. Intervention participants received both SOC and peer counselling. A generalized estimating equation was used to compare pre-post diagnosis high-risk behaviour change; logistic regression was used to assess the likelihood of practicing high-risk behaviours between intervention and SOC participants. Both intent-to-treat and per-protocol (full-dosage) approaches were used for the analyses. For pre- and post-diagnosis comparisons, multiple partnership fell from 50% to 16% (p peer counselling was more likely to reduce insertive anal sex (AOR = 0.65; 95% CI: 0.45 to 0.94), condomless anal sex (AOR = 0.27; 95% CI: 0.10 to 0.64) and illicit drug use (AOR = 0.32; 95% CI: 0.16 to 0.64). In the per-protocol analysis, peer counselling was associated with a lower likelihood of using illicit drug (OR = 0.23; 95% CI: 0.07 to 0.81) and having condomless vaginal sex with women (OR = 0.12; 95% CI: 0.07 to 0.98). We observed a 14 to 43% decrease in the prevalence of selected high-risk behaviours after HIV diagnosis. Peer counselling had a greater impact in reducing condomless anal sex with men, illicit drug use and condomless vaginal sex with women over time. Future studies with exclusive peer-counselling arm are necessary to test its efficacy and effectiveness among Chinese MSM. Clinical Trial Number: NCT01904877. © 2018

HIV provider and patient perspectives on the Development of a Health Department “Data to Care” Program: a qualitative study

Directory of Open Access Journals (Sweden)

Julia C. Dombrowski

2016-06-01

Full Text Available Abstract Background U.S. health departments have not historically used HIV surveillance data for disease control interventions with individuals, but advances in HIV treatment and surveillance are changing public health practice. Many U.S. health departments are in the early stages of implementing “Data to Care” programs to assists persons living with HIV (PLWH with engaging in care, based on information collected for HIV surveillance. Stakeholder engagement is a critical first step for development of these programs. In Seattle-King County, Washington, the health department conducted interviews with HIV medical care providers and PLWH to inform its Data to Care program. This paper describes the key themes of these interviews and traces the evolution of the resulting program. Methods Disease intervention specialists conducted individual, semi-structured qualitative interviews with 20 PLWH randomly selected from HIV surveillance who had HIV RNA levels >10,000 copies/mL in 2009–2010. A physician investigator conducted key informant interviews with 15 HIV medical care providers. Investigators analyzed de-identified interview transcripts, developed a codebook of themes, independently coded the interviews, and identified codes used most frequently as well as illustrative quotes for these key themes. We also trace the evolution of the program from 2010 to 2015. Results PLWH generally accepted the idea of the health department helping PLWH engage in care, and described how hearing about the treatment experiences of HIV seropositive peers would assist them with engagement in care. Although many physicians were supportive of the Data to Care concept, others expressed concern about potential health department intrusion on patient privacy and the patient-physician relationship. Providers emphasized the need for the health department to coordinate with existing efforts to improve patient engagement. As a result of the interviews, the Data to Care

Student Perceptions of Peer Credibility Based on Email Addresses

Science.gov (United States)

Livermore, Jeffrey A.; Scafe, Marla G.; Wiechowski, Linda S.; Maier, David J.

2013-01-01

The purpose of this study was to evaluate students' perceptions of their peer's credibility based on email addresses. The survey was conducted at a community college in Michigan where all students were registered and actively taking at least one course. The survey results show that a student's selection of an email address does influence other…

HIV prevention among transgender women in Latin America: implementation, gaps and challenges.

Science.gov (United States)

Silva-Santisteban, Alfonso; Eng, Shirley; de la Iglesia, Gabriela; Falistocco, Carlos; Mazin, Rafael

2016-01-01

Transgender women are the population most vulnerable to HIV in Latin America, with prevalence between 18 and 38%. Although the region has improved antiretroviral coverage, there is an urgent need to strengthen HIV prevention for key populations to meet regional targets set by governments. We conducted an assessment on the state of HIV prevention among transgender women in Latin America. We conducted a desk review of Global AIDS Response Progress Reports, national strategic plans, technical reports and peer-reviewed articles from 17 Latin American countries published through January 2015. The review was preceded by 12 semi-structured interviews with UNAIDS and Pan American Health Organization officers and a discussion group with transgender women regional leaders, to guide the identification of documents. We assessed access to, implementation and coverage of programmes; legal frameworks; community participation; inclusion of new strategies; and alignment with international recommendations. Overall, prevention activities in the region focus on condom distribution, diagnosis of sexually transmitted infections and peer education, mostly delivered at health facilities, with limited community involvement. Argentina and Uruguay have implemented structural interventions to address social inclusion. Argentina, Brazil and Mexico have adopted early initiation of antiretroviral therapy and treatment as prevention strategies. The other countries do not have substantial tailored interventions and consider the trans population a sub-population of men who have sex with men in data collection and programme implementation. Limited coverage of services, discrimination and a deep-seated mistrust of the health system among transgender women are the main barriers to accessing HIV prevention services. Promising interventions include health services adapted to transgender women in Mexico; LGBT-friendly clinics in Argentina that incorporate community and health workers in mixed teams; task

Knowledge of HIV-AIDS a dominant factor of antiretroviral therapeutic adherence in women with HIV-AIDS

Directory of Open Access Journals (Sweden)

Surilena

2015-08-01

Full Text Available Background Antiretroviral therapy adherence (ART adherence is a factor significantly extending life expectancy of people living with HIV/AIDS. The objective of this study was determine several factors on ART adherence in women infected with HIV/AIDS. Methods A cross-sectional study involving 99 women with HIV/AIDS who were infected through their sexual partner or spouse was conducted in Dharmais Hospital between March and August 2014. The instruments used were demographic and self-esteem questionnaires, Hamilton rating scale for depression, Hamilton rating scale for anxiety, knowledge, perception of ART benefits and limitations, family support, peer support as well as assessment of ART adherence. The knowledge questionnaire has been validated with Cronbach’s alpha = 0.823. Data were analyzed using Chi-Square test and multivariate logistic regression. Results A total of 99 women with HIV/AIDS participated in the study, with an age range of 30- 60 years and mean age of 36 ± 3.72 years. A total of 57.58% of participants showed poor ART adherence. Multivariate logistic regression analysis showed that knowledge, ART side effects, depression, peer support and ARV availability significantly affected ART adherence (p<0.05. The most dominant factor affecting ART adherence was knowledge, with OR = 64.02 (95% CI 4.99-670.12. Conclusion With good knowledge about HIV/AIDS infection, ART benefits, and possible ARV side effects, women living with HIV/AIDS are expected to carry out ART adherence according to the recommended rules.

A call for differentiated approaches to delivering HIV services to key populations.

Science.gov (United States)

Macdonald, Virginia; Verster, Annette; Baggaley, Rachel

2017-07-21

Key populations (KPs) are disproportionally affected by HIV and have low rates of access to HIV testing and treatment services compared to the broader population. WHO promotes the use of differentiated approaches for reaching and recruiting KP into the HIV services continuum. These approaches may help increase access to KPs who are often criminalized or stigmatized. By catering to the specific needs of each KP individual, differentiated approaches may increase service acceptability, quality and coverage, reduce costs and support KP members in leading the HIV response among their communities. WHO recommends the implementation of community-based and lay provider administered HIV testing services. Together, these approaches reduce barriers and costs associated with other testing strategies, allow greater ownership in HIV programmes for KP members and reach more people than do facility-based services. Despite this evidence availability and support for them is limited. Peer-driven interventions have been shown to be effective in engaging, recruiting and supporting clients. Some programmes employ HIV-positive or non-PLHIV "peer navigators" and other staff to provide case management, enrolment and/or re-enrolment in care and treatment services. However, a better understanding of the impact, cost effectiveness and potential burden on peer volunteers is required. Task shifting and non-facility-based service locations for antiretroviral therapy (ART) initiation and maintenance and antiretroviral (ARV) distribution are recommended in both the consolidated HIV treatment and KP guidelines of WHO. These approaches are accepted in generalized epidemics and for the general population where successful models exist; however, few organizations provide or initiate ART at KP community-based services. The application of a differentiated service approach for KP could increase the number of people who know their status and receive effective and sustained prevention and treatment for HIV

Marginalization and social change processes among lesbian, gay, bisexual and transgender persons in Swaziland: implications for HIV prevention.

Science.gov (United States)

H Logie, Carmen; Perez-Brumer, Amaya; Jenkinson, Jesse; Madau, Veli; Nhlengethwa, Winnie; Baral, Stefan

2018-05-30

Swaziland has among the highest national adult HIV prevalence globally. There is limited knowledge of HIV vulnerabilities and prevention engagement among lesbian, gay, bisexual and transgender (LGBT) persons in the context of Swaziland's criminalization of consensual same-sex practices. This study explored social processes of marginalization to assess how they could potentiate HIV vulnerabilities and limit engagement in HIV prevention services. Additionally, we assessed positive change to better understand existing strategies employed by LGBT persons to challenge these HIV prevention barriers. Guided by community-based research methodology and conducted in Mbabane and Manzini, Swaziland, data were collected by LGBT peer-research assistants (PRA) in collaboration with an LGBT community organization in Manzini. Semi-structured interviews were conducted by trained PRAs and explored HIV prevention, including experiences of stigma and coping. Audio files were transcribed verbatim, translated to English, and analyzed using thematic techniques. Among participants (n = 51; mean age: 26.47, SD: 4.68), 40 self-identifed as gay or lesbian (78.4%), 11 bisexual (22.6%), and 12 (23.5%) identified as transgender. Findings highlighted three primary processes of marginalization and positive change in structural, community, and internal domains. First, structural marginalization, which included criminalization, healthcare discrimination, and a scarcity of LGBT tailored HIV prevention resources was challenged by grassroots networks created to access and share specific HIV resources with LGBT persons and the Ministry of Health. Second, community marginalization included stigma and multi-dimensional forms of violence, however, this was met with LGBT persons providing mutual peer support, including for accessing HIV testing services. Thirdly, internal marginalization comprised of self-stigma and associated sexual risk practices was contrasted with coping strategies focused on self

Economic Evaluation of Community-Based HIV Prevention Programs in Ontario: Evidence of Effectiveness in Reducing HIV Infections and Health Care Costs.

Science.gov (United States)

Choi, Stephanie K Y; Holtgrave, David R; Bacon, Jean; Kennedy, Rick; Lush, Joanne; McGee, Frank; Tomlinson, George A; Rourke, Sean B

2016-06-01

Investments in community-based HIV prevention programs in Ontario over the past two and a half decades are assumed to have had an impact on the HIV epidemic, but they have never been systematically evaluated. To help close this knowledge gap, we conducted a macro-level evaluation of investment in Ontario HIV prevention programs from the payer perspective. Our results showed that, from 1987 to 2011, province-wide community-based programs helped to avert a total of 16,672 HIV infections, saving Ontario's health care system approximately $6.5 billion Canadian dollars (range 4.8-7.5B). We also showed that these community-based HIV programs were cost-saving: from 2005 to 2011, every dollar invested in these programs saved about $5. This study is an important first step in understanding the impact of investing in community-based HIV prevention programs in Ontario and recognizing the impact that these programs have had in reducing HIV infections and health care costs.

HIV testing and risk perceptions: a qualitative analysis of secondary school students in Kampala, Uganda

Directory of Open Access Journals (Sweden)

George Aluzimbi

2017-07-01

Full Text Available The purpose of this paper is to explore the perceptions of self-reported HIV testing and risk behavior among sexually active adolescents and youth in secondary schools in Kampala Uganda. This was a cross-sectional survey conducted between June and October 2010 among secondary school students in Kampala, Uganda. Forty eight (48 students across the 54 schools were purposively selected for the qualitative sub-study based on their responses to particular questions. We thematically analyzed 28 interviews for our qualitative study using Nvivo software. Drug and alcohol use coupled with peers pressure impaired students’ perceptions towards HIV risk and therefore increased their susceptibility to HIV risk behaviors. Of the 28 scripts analyzed, 82% (23/28 had ever had sexual partners, 79% (22/28 were currently sexually active, and 57% (16/28 had ever been tested for HIV. In conclusion, most adolescents interviewed did not perceive HIV testing to be important to HIV prevention and reported low perception of susceptibility to HIV infection. Development of an adolescent HIV prevention model is important in improving uptake of HIV services.

How peer conversations about HIV/AIDS media messages affect comprehension and beliefs of young South African women

Directory of Open Access Journals (Sweden)

E. Lubinga

2016-01-01

Full Text Available Most existent research on the effects of interpersonal discussions about health campaign messages is based on surveys. In this study, we analysed actual conversations about an HIV/AIDS poster to find out possible effects. Young South African women in 59 dyads (n = 118 participated in conversations about a deliberately puzzling HIV and AIDS poster that cautioned the target group to be faithful to one sexual partner. We measured their comprehension of the poster and beliefs about the message, before and after the conversations. Overall, actual comprehension (AC was low, and we observed a large discrepancy between actual and perceived comprehension. In general, conversations did not improve AC. It proved to be even more probable that a correct interpretation before a conversation turned into an incorrect interpretation than the other way around. However, having a well-informed conversation partner increased the chance of acquiring adequate subsequent comprehension. We found, in general, that conversations did not decrease undesirable beliefs. One important undesirable belief even became reinforced after the conversations. Conversations among peers might be valuable in health campaigns, but our study shows that intended positive effects do not automatically follow.

Student Voices: Perspectives on Peer-to-Peer Sexual Health Education

Science.gov (United States)

Layzer, Carolyn; Rosapep, Lauren; Barr, Sherry

2017-01-01

Background: This process study is a companion to a randomized evaluation of a school-based, peer-led comprehensive sexual health education program, Teen Prevention Education Program (Teen PEP), in which 11th- and 12th-grade students are trained by school health educators to conduct informative workshops with ninth-grade peers in schools in North…

Barriers and Facilitators to HIV Testing Among Zambian Female Sex Workers in Three Transit Hubs.

Science.gov (United States)

Chanda, Michael M; Perez-Brumer, Amaya G; Ortblad, Katrina F; Mwale, Magdalene; Chongo, Steven; Kamungoma, Nyambe; Kanchele, Catherine; Fullem, Andrew; Barresi, Leah; Bärnighausen, Till; Oldenburg, Catherine E

2017-07-01

Zambia has a generalized HIV epidemic, and HIV is concentrated along transit routes. Female sex workers (FSWs) are disproportionately affected by the epidemic. HIV testing is the crucial first step for engagement in HIV care and HIV prevention activities. However, to date little work has been done with FSWs in Zambia, and little is known about barriers and facilitators to HIV testing in this population. FSW peer educators were recruited through existing sex worker organizations for participation in a trial related to HIV testing among FSWs. We conducted five focus groups with FSW peer educators (N = 40) in three transit towns in Zambia (Livingstone, Chirundu, and Kapiri Mposhi) to elicit community norms related to HIV testing. Emerging themes demonstrated barriers and facilitators to HIV testing occurring at multiple levels, including individual, social network, and structural. Stigma and discrimination, including healthcare provider stigma, were a particularly salient barrier. Improving knowledge, social support, and acknowledgment of FSWs and women's role in society emerged as facilitators to testing. Interventions to improve HIV testing among FSWs in Zambia will need to address barriers and facilitators at multiple levels to be maximally effective.

Structural Network Position and Performance of Health Leaders Within an HIV Prevention Trial.

Science.gov (United States)

Mulawa, Marta I; Yamanis, Thespina J; Kajula, Lusajo J; Balvanz, Peter; Maman, Suzanne

2018-04-28

The effectiveness of peer leaders in promoting health may depend on the position they occupy within their social networks. Using sociocentric (whole network) and behavioral data from the intervention arm of a cluster-randomized HIV prevention trial in Dar es Salaam, Tanzania, we used generalized linear models with standardized predictors to examine the association between heath leaders' baseline structural network position (i.e., in-degree and betweenness centrality) and their 12-month self-reported (1) confidence in educating network members about HIV and gender-based violence (GBV) and (2) number of past-week conversations about HIV and GBV. As in-degree centrality increased, leaders reported fewer HIV-related conversations. As betweenness centrality increased, leaders reported greater number of conversations about GBV. Network position was not significantly associated with confidence in discussing either topic. Our results suggest that peer leaders who occupy spaces between sub-groups of network members may be more effective in engaging their peers in sensitive or controversial topics like GBV than more popular peer leaders.

Noninferiority of a task-shifting HIV care and treatment model using peer counselors and nurses among Ugandan women initiated on ART: evidence from a randomized trial.

Science.gov (United States)

Kiweewa, Flavia M; Wabwire, Deo; Nakibuuka, Jessica; Mubiru, Mike; Bagenda, Danstan; Musoke, Phillippa; Fowler, Mary G; Antelman, Gretchen

2013-08-01

To assess the noninferiority of a task-shifting HIV treatment model relying on peer counselors and nurses compared with a physician-centered model among HIV-1-positive women initiated on antiretroviral therapy (ART) at a prevention of mother-to-child transmission clinic in Mulago Hospital, Uganda. HIV-1-infected ART eligible naive women were randomized to either nurse-peer (intervention) or doctor-counselor (standard model) arm. The primary endpoint was virologic success defined attaining a viral load baseline) and pill count. Data on 85 participants were analyzed (n = 45 in the intervention and n = 40 in the standard model). The proportion of participants with virologic success was similar in the standard and intervention models [91% versus 88% respectively; difference, 3%; 95% confidence interval (CI): -11% to 12%]. Probability of viral detection at 6-12 months' time point was similar in the 2 models (log-rank test P = 0.73). Immunologic and pill count indicators were also similar in the intervention and standard models, with mean CD4 increase of 217 versus 206 cells per microliter (difference, 11; 95% CI: -60 to 82 cells/μL) and pill counts of 99.8% versus 99.7% (difference, 0.0; 95% CI: -5% to 5%) respectively. Nurses and peer counselors were not inferior in providing ART follow-up care to postpartum women, an approach that may help deliver treatment to many more HIV-infected people.

Conducting qualitative research in the context of pre-existing peer and collegial relationships.

Science.gov (United States)

McDermid, Fiona; Peters, Kath; Jackson, Debra; Daly, John

2014-05-01

To highlight issues and challenges faced in recruitment and interviewing during a study that sought to explore the transition of nurses into academic life and the associated ethical implications. This paper explores the challenges faced in conducting research where the potential participants are peers and workplace colleagues. There are advantages when conducting research with those among whom a pre-existing relationship is shared. However, difficulties can also arise. A methodological review was undertaken. Key database searches included CINAHL, MEDLINE, PubMed, Scopus and Google Scholar using the keywords as search terms. Studies were included if they described in detail issues surrounding qualitative interviewing of peers and colleagues. Management of the issues involved is discussed, with emphasis on boundaries, trust and rapport, the use of self-disclosure and maintaining confidentiality. Research involving peers and colleagues has received relatively little consideration in the literature. There are difficulties associated with interviewing participants with whom the researcher has a pre-existing and ongoing relationship in the same organisation. To ensure ethical conduct, strategies can be used to mitigate negative situations such as issues surrounding dual roles, practising reflexivity, trust and rapport, self-disclosure and confidentiality. It is imperative that dual roles are declared and acknowledged. Researchers need to be mindful of the difficulties that may occur and prioritise participants' confidentiality and privacy.

Parental HIV/AIDS status and death, and children's psychological wellbeing

Directory of Open Access Journals (Sweden)

Doku Paul

2009-11-01

Full Text Available Abstract Background Ghana has an estimated one million orphans, 250,000 are due to AIDS parental deaths. This is the first study that examined the impact of parental HIV/AIDS status and death on the mental health of children in Ghana. Methods In a cross-sectional survey, 4 groups of 200 children (children whose parents died of AIDS, children whose parents died of causes other than AIDS, children living with parents infected with HIV/AIDS, and non-orphaned children whose parents are not known to be infected with HIV/AIDS aged between 10 and 19 were interviewed on their hyperactivity, emotional, conduct, and peer problems using the Strengths and Difficulties Questionnaire. Results Children whose parents died of AIDS showed very high levels of peer problems [F (3,196 = 7.34, p Conclusion Orphans and children living with parents infected with HIV/AIDS are at heightened risks for emotional and behavioural disorders and that efforts to address problems in children affected by HIV/AIDS must focus on both groups of children. Parallel to this, researchers should see these findings as generated hypotheses (rather than conclusions calling for further exploration of specific causal linkages between HIV/AIDS and children's mental health, using more rigorous research tools and designs.

Implementing peer support in secondary schools: facing the ...

African Journals Online (AJOL)

Erna Kinsey

high-risk behaviour related to HIV/AIDS, substance abuse, and various forms of crime. Peer supporters .... nator from the Gauteng Department of Education to implement the project in ..... and aggression, and being idealised by their peers.

Safety of oral tenofovir disoproxil fumarate-based HIV pre-exposure prophylaxis use in lactating HIV-uninfected women.

Science.gov (United States)

Mugwanya, Kenneth K; John-Stewart, Grace; Baeten, Jared

2017-07-01

In settings where HIV is prevalent in heterosexual populations, pregnancy and postpartum breastfeeding periods can be associated with substantial HIV acquisition risk. Pre-exposure prophylaxis (PrEP) with daily oral tenofovir disoproxil fumarate (TDF)/emtricitabine is an attractive HIV prevention option for women who are lactating but data are limited on its safety during the lactation period. Areas covered: We provide a concise synthesis and summary of current evidence on the safety of TDF-based PrEP during breastfeeding. We conducted a review, searching Pubmed database and major PrEP conferences for primary studies with TDF-based PrEP exposure during postpartum breastfeeding. Expert opinion: TDF-based oral PrEP is an effective female-controlled HIV prevention option. There is evidence supporting the safety of TDF use for infant outcomes during breastfeeding in antiretroviral treatment regimens for HIV and hepatitis B virus, and more limited, but consistently safe, data from use of TDF as PrEP. The potential for risk is arguably outweighed for at-risk individuals by HIV prevention benefits, including indirect protection to the infant as a result of preventing HIV in the breastfeeding mother. As PrEP delivery is scaled up in heterosexual populations in high HIV prevalence settings and for at-risk persons in other settings, implementation science studies can provide a framework to increase the accrual of safety, acceptability, and use data related to PrEP during lactation.

An integrated 2-year clinical skills peer tutoring scheme in a UK-based medical school: perceptions of tutees and peer tutors

Science.gov (United States)

2018-01-01

Background Several benefits of peer tutoring in medical school teaching have been described. However, there is a lack of research on the perceptions of peer tutoring, particularly from tutees who partake in a long-term clinical skills scheme integrated into the medical school curriculum. This study evaluates the opinions of preclinical tutees at the end of a 2-year peer-tutored clinical skills program and peer tutors themselves. Methods A cross-sectional study was conducted in a UK-based medical school that primarily utilizes peer tutoring for clinical skills teaching. A questionnaire was designed to assess the views of preclinical tutees and peer tutors. Likert scales were used to grade responses and comment boxes to collect qualitative data. Results Sixty-five questionnaires were collected (52 tutees, 13 peer tutors). Seventy-nine percent of students felt satisfied with their teaching, and 70% felt adequately prepared for clinical placements. Furthermore, 79% believed that peer tutoring is the most effective method for clinical skills teaching. When compared to faculty teaching, tutees preferred being taught by peer tutors (63%), felt more confident (73%), and were more willing to engage (77%). All peer tutors felt that teaching made them more confident in their Objective Structured Clinical Examination performance, and 91% agreed that being a tutor made them consider pursuing teaching in the future. Thematic analysis of qualitative data identified 3 themes regarding peer tutoring: a more comfortable environment (69%), a more personalized teaching approach (34%), and variation in content taught (14%). Conclusion Preclinical tutees prefer being taught clinical skills by peer tutors compared to faculty, with the peer tutors also benefitting. Studies such as this, looking at long-term schemes, further validate peer tutoring and may encourage more medical schools to adopt this method as an effective way of clinical skills teaching. PMID:29922105

HIV prevention among transgender women in Latin America: implementation, gaps and challenges

Science.gov (United States)

Silva-Santisteban, Alfonso; Eng, Shirley; de la Iglesia, Gabriela; Falistocco, Carlos; Mazin, Rafael

2016-01-01

Introduction Transgender women are the population most vulnerable to HIV in Latin America, with prevalence between 18 and 38%. Although the region has improved antiretroviral coverage, there is an urgent need to strengthen HIV prevention for key populations to meet regional targets set by governments. We conducted an assessment on the state of HIV prevention among transgender women in Latin America. Methods We conducted a desk review of Global AIDS Response Progress Reports, national strategic plans, technical reports and peer-reviewed articles from 17 Latin American countries published through January 2015. The review was preceded by 12 semi-structured interviews with UNAIDS and Pan American Health Organization officers and a discussion group with transgender women regional leaders, to guide the identification of documents. We assessed access to, implementation and coverage of programmes; legal frameworks; community participation; inclusion of new strategies; and alignment with international recommendations. Results and discussion Overall, prevention activities in the region focus on condom distribution, diagnosis of sexually transmitted infections and peer education, mostly delivered at health facilities, with limited community involvement. Argentina and Uruguay have implemented structural interventions to address social inclusion. Argentina, Brazil and Mexico have adopted early initiation of antiretroviral therapy and treatment as prevention strategies. The other countries do not have substantial tailored interventions and consider the trans population a sub-population of men who have sex with men in data collection and programme implementation. Limited coverage of services, discrimination and a deep-seated mistrust of the health system among transgender women are the main barriers to accessing HIV prevention services. Promising interventions include health services adapted to transgender women in Mexico; LGBT-friendly clinics in Argentina that incorporate

HIV prevention among male clients of female sex workers in Kaolack, Senegal: results of a peer education program.

Science.gov (United States)

Leonard, L; Ndiaye, I; Kapadia, A; Eisen, G; Diop, O; Mboup, S; Kanki, P

2000-02-01

This article reports the results of a peer-led HIV prevention education and condom promotion program among transport workers in Kaolack, Senegal. As part of a 2-year longitudinal follow-up study, changes in men's AIDS-related knowledge, sexual behavior, condom use, and perceived barriers to condom use were evaluated by self-reports obtained from a systematic sample of transport workers interviewed before and after intervention. In addition to men's self-reports, preintervention and postintervention data on men's sexual and condom use behavior were gathered from a sample of licensed, commercial sex workers, who cited transport workers as their primary source of clients. Significant increases in men's HIV-related knowledge, previous use of condoms (from 30.4% to 53.5%), and consistent condom use with regular sex partners were documented over the study period, as were significant declines in perceived barriers to condom use. Though men reported significantly fewer sexual encounters with casual and commercial partners at follow-up compared to baseline, these data were unreliable. Women's postintervention reports indicate that a greater proportion of clients (including, but not limited to transport workers) "always" agree to use condoms (p money for unprotected sex (p taking greater initiative in the mechanics of condom use (supplying the condom, putting it on, and taking it off) than they did prior to the intervention, and significantly (p < .05) fewer women think that most of their clients know how to use a condom. The findings indicate that the peer-mediated intervention had a positive impact on several important outcomes measured and suggest that HIV prevention efforts need to focus on male client groups despite the logistical and methodological challenges.

Two Dimensional Array Based Overlay Network for Balancing Load of Peer-to-Peer Live Video Streaming

International Nuclear Information System (INIS)

Ibrahimy, Abdullah Faruq Ibn; Rafiqul, Islam Md; Anwar, Farhat; Ibrahimy, Muhammad Ibn

2013-01-01

The live video data is streaming usually in a tree-based overlay network or in a mesh-based overlay network. In case of departure of a peer with additional upload bandwidth, the overlay network becomes very vulnerable to churn. In this paper, a two dimensional array-based overlay network is proposed for streaming the live video stream data. As there is always a peer or a live video streaming server to upload the live video stream data, so the overlay network is very stable and very robust to churn. Peers are placed according to their upload and download bandwidth, which enhances the balance of load and performance. The overlay network utilizes the additional upload bandwidth of peers to minimize chunk delivery delay and to maximize balance of load. The procedure, which is used for distributing the additional upload bandwidth of the peers, distributes the additional upload bandwidth to the heterogeneous strength peers in a fair treat distribution approach and to the homogeneous strength peers in a uniform distribution approach. The proposed overlay network has been simulated by Qualnet from Scalable Network Technologies and results are presented in this paper

Two Dimensional Array Based Overlay Network for Balancing Load of Peer-to-Peer Live Video Streaming

Science.gov (United States)

Faruq Ibn Ibrahimy, Abdullah; Rafiqul, Islam Md; Anwar, Farhat; Ibn Ibrahimy, Muhammad

2013-12-01

The live video data is streaming usually in a tree-based overlay network or in a mesh-based overlay network. In case of departure of a peer with additional upload bandwidth, the overlay network becomes very vulnerable to churn. In this paper, a two dimensional array-based overlay network is proposed for streaming the live video stream data. As there is always a peer or a live video streaming server to upload the live video stream data, so the overlay network is very stable and very robust to churn. Peers are placed according to their upload and download bandwidth, which enhances the balance of load and performance. The overlay network utilizes the additional upload bandwidth of peers to minimize chunk delivery delay and to maximize balance of load. The procedure, which is used for distributing the additional upload bandwidth of the peers, distributes the additional upload bandwidth to the heterogeneous strength peers in a fair treat distribution approach and to the homogeneous strength peers in a uniform distribution approach. The proposed overlay network has been simulated by Qualnet from Scalable Network Technologies and results are presented in this paper.

Building Flexible Manufacturing Systems Based on Peer-Its

Directory of Open Access Journals (Sweden)

M. Hechinger

2008-02-01

Full Text Available Peer-to-peer computing principles have started to pervade into mechanical control systems, inducing a paradigm shift from centralized to autonomic control. We have developed a self-contained, miniaturized, universal and scalable peer-to-peer based hardware-software system, the peer-it platform, to serve as a stick-on computer solution to raise real-world artefacts like, for example, machines, tools, or appliances towards technology-rich, autonomous, self-induced, and context-aware peers, operating as spontaneously interacting ensembles. The peer-it platform integrates sensor, actuator, and wireless communication facilities on the hardware level, with an object-oriented, component-based coordination framework at the software level, thus providing a generic platform for sensing, computing, controlling, and communication on a large scale. The physical appearance of a peer-it supports pinning it to real-world artefacts, while at the same time integrating those artefacts into a mobile ad hoc network of peers. Peer-it networks thus represent ensembles of coordinated artefacts, exhibiting features of autonomy like self-management at the node level and self-organization at the network level. We demonstrate how the peer-it system implements the desired flexibility in automated manufacturing systems to react in the case of changes, whether intended or unexpectedly occuring. The peer-it system enables machine flexibility in that it adapts production facilities to produce new types of products, or change the order of operation executed on parts instantaneously. Secondly, it enables routing flexibility, that is, the ability to use multiple machines to spontaneously perform the same operation on one part alternatively (to implement autonomic fault tolerance or to absorb large-scale changes in volume, capacity, or capability (to implement autonomic scalability.

When human immunodeficiency virus (HIV) treatment goals conflict with guideline-based opioid prescribing: A qualitative study of HIV treatment providers.

Science.gov (United States)

Starrels, Joanna L; Peyser, Deena; Haughton, Lorlette; Fox, Aaron; Merlin, Jessica S; Arnsten, Julia H; Cunningham, Chinazo O

2016-01-01

Human immunodeficiency virus (HIV)-infected patients have a high prevalence of chronic pain and opioid use, making HIV care a critical setting for improving the safety of opioid prescribing. Little is known about HIV treatment providers' perspectives about opioid prescribing to patients with chronic pain. The authors administered a questionnaire and conducted semistructured telephone interviews with 18 HIV treatment providers (infectious disease specialists, general internists, family medicine physicians, nurse practitioners, and physician assistants) in Bronx, NY. Open-ended interview questions focused on providers' experiences, beliefs, and attitudes about opioid prescribing and about the use of guideline-based opioid prescribing practices (conservative prescribing, and monitoring for and responding to misuse). Transcripts were thematically analyzed using a modified grounded theory approach. Eighteen HIV treatment providers included 13 physicians, four nurse practitioners, and one physician assistant. They were 62% female, 56% white, and practiced as HIV treatment providers for a mean of 14.6 years. Most reported always or almost always using opioid treatment agreements (56%) and urine drug testing (61%) with their patients on long-term opioid therapy. HIV treatment providers tended to view opioid prescribing for chronic pain within the "HIV paradigm," a set of priorities and principles defined by three key themes: (1) primacy of HIV goals, (2) familiarity with substance use, and (3) the clinician as ally. The HIV paradigm sometimes supported, and sometimes conflicted with, guideline-based opioid prescribing practices. For HIV treatment providers, perceived alignment with the HIV paradigm determined whether and how guideline-based opioid prescribing practices were adopted. For example, the primacy of HIV goals superseded conservative opioid prescribing when providers prescribed opioids with the goal of retaining patients in HIV care. These findings highlight

Intervention Mapping to develop a Social Cognitive Theory-based intervention for chronic pain tailored to individuals with HIV.

Science.gov (United States)

Merlin, Jessica S; Young, Sarah R; Johnson, Mallory O; Saag, Michael; Demonte, William; Kerns, Robert; Bair, Matthew J; Kertesz, Stefan; Turan, Janet M; Kilgore, Meredith; Clay, Olivio J; Pekmezi, Dorothy; Davies, Susan

2018-06-01

Chronic pain is an important comorbidity among individuals with HIV. Behavioral interventions are widely regarded as evidence-based, efficacious non-pharmacologic interventions for chronic pain in the general population. An accepted principle in behavioral science is that theory-based, systematically-developed behavioral interventions tailored to the unique needs of a target population are most likely to be efficacious. Our aim was to use Intervention Mapping to systematically develop a Social Cognitive Theory (SCT)-based intervention for chronic pain tailored to individuals with HIV that will improve pain intensity and pain-related functional impairment. Our Intervention Mapping process was informed by qualitative inquiry of 24 patients and seven providers in an HIV primary care clinic. The resulting intervention includes group and one-on-one sessions and peer and staff interventionists. We also developed a conceptual framework that integrates our qualitative findings with SCT-based theoretical constructs. Using this conceptual framework as a guide, our future work will investigate the intervention's impact on chronic pain outcomes, as well as our hypothesized proximal mediators of the intervention's effect.

Should trained lay providers perform HIV testing? A systematic review to inform World Health Organization guidelines.

Science.gov (United States)

Kennedy, C E; Yeh, P T; Johnson, C; Baggaley, R

2017-12-01

New strategies for HIV testing services (HTS) are needed to achieve UN 90-90-90 targets, including diagnosis of 90% of people living with HIV. Task-sharing HTS to trained lay providers may alleviate health worker shortages and better reach target groups. We conducted a systematic review of studies evaluating HTS by lay providers using rapid diagnostic tests (RDTs). Peer-reviewed articles were included if they compared HTS using RDTs performed by trained lay providers to HTS by health professionals, or to no intervention. We also reviewed data on end-users' values and preferences around lay providers preforming HTS. Searching was conducted through 10 online databases, reviewing reference lists, and contacting experts. Screening and data abstraction were conducted in duplicate using systematic methods. Of 6113 unique citations identified, 5 studies were included in the effectiveness review and 6 in the values and preferences review. One US-based randomized trial found patients' uptake of HTS doubled with lay providers (57% vs. 27%, percent difference: 30, 95% confidence interval: 27-32, p lay providers. Studies from Cambodia, Malawi, and South Africa comparing testing quality between lay providers and laboratory staff found little discordance and high sensitivity and specificity (≥98%). Values and preferences studies generally found support for lay providers conducting HTS, particularly in non-hypothetical scenarios. Based on evidence supporting using trained lay providers, a WHO expert panel recommended lay providers be allowed to conduct HTS using HIV RDTs. Uptake of this recommendation could expand HIV testing to more people globally.

Facilitating factors of self-care among HIV-positive young women in Iran: a qualitative study.

Science.gov (United States)

Oskouie, Fatemeh; Kashefi, Farzaneh; Rafii, Forough; Gouya, Mohammad Mehdi; Vahid-Dastjerdi, Marzieh

2018-02-05

Background Providing care for chronic disease such as HIV is a growing challenge in the world. In order to address the challenges of linkage and care in chronic disease management, we need to identify factors that can influence people to get more involved in self-care. This study was part of an extensive qualitative study conducted in Tehran, Iran in 2016. Methods The data were collected through semi-structured interviews conducted on 25 women with HIV, and were analyzed using grounded theory. Four main themes were identified as facilitating self-care among participants: health system support, clinicians' support, family support and improved life expectancy. Sub-themes that emerged were free HIV tests; free medication; free membership in positive clubs; free psychological consultation; positive attitudes and friendly behavior from clinic staff; telephone follow up; support from husbands, mothers and peers; hope for recovery; hope for the future; and love for own children. Results Our results showed that, providing appropriate support and services, as well as a positive attitude of society towards HIV positive women, can contribute to adherence to self-care in young women with HIV. Conclusion Understanding the facilitating factors based on the patients' experiences can contribute to the development of new policies and procedures to improve the care of these patients.

The direct effects of inattention and hyperactivity/impulsivity on peer problems and mediating roles of prosocial and conduct problem behaviors in a community sample of children.

Science.gov (United States)

Andrade, Brendan F; Tannock, Rosemary

2013-11-01

This study tested whether children's symptoms of inattention and hyperactivity/impulsivity were associated with peer problems and whether these associations were mediated by conduct problems and prosocial behaviors. A community sample of 500 children, including 245 boys and 255 girls, who ranged in age from 6 to 9 years (M = 7.6, SD = 0.91) were recruited. Teachers' report of children's inattention, hyperactivity/impulsivity, conduct problems, prosocial behaviors, and peer problems was collected. Symptoms of inattention and hyperactivity/impulsivity were significantly positively associated with peer problems. Conduct problems were associated with more peer problems and prosocial behaviors with less peer problems. Conduct problems and prosocial behaviors partially mediated the association between hyperactivity/impulsivity and peer problems and fully mediated the inattention-peer problems association. Findings show that prosocial behaviors and conduct problems are important variables that account for some of the negative impact of symptoms of inattention and hyperactivity/impulsivity on peer functioning.

Effectiveness of an Integrated Community- and Clinic-Based Intervention on HIV Testing, HIV Knowledge, and Sexual Risk Behavior of Young Men Who Have Sex With Men in Myanmar.

Science.gov (United States)

Aung, Poe Poe; Ryan, Claire; Bajracharya, Ashish; Pasricha, Naanki; Thein, Zaw Win; Agius, Paul A; Sein, Than Tun; Willenberg, Lisa; Soe, Ei Mon; Zaw, Ne Tun; Tun, Waimar; Yam, Eileen; Luchters, Stanley

2017-02-01

Young men who have sex with men (YMSM) in Myanmar are disproportionately affected by HIV, with prevalence five times that of the general population. The Link Up project implemented an intervention using peer education and outreach providing education and counseling on health seeking around sexually transmitted infections and reproductive health, combined with focused clinic capacity building to improve the sexual and reproductive health of YMSM. This study aimed to evaluate the effectiveness and acceptability of the intervention. Using a mixed-methods approach, and employing a quasi-experimental design, we conducted two quantitative repeat cross-sectional surveys in purposively selected control (no intervention) and intervention townships, before and after implementation of the Link Up intervention. Respondent-driven sampling was used to recruit YMSM aged 15-24 years, and study participants were administered a structured questionnaire assessing intervention exposure, health service access, knowledge of HIV, and sexual risk behavior. Focus group discussions were held to elicit perspectives on the use and acceptability of the health services and peer outreach. At baseline, 314 YMSM were recruited in the intervention townships and 309 YMSM in the control townships. At end line, 267 (intervention) and 318 (control) YMSM were recruited. Coverage of the program was relatively low, with one-third of participants in the intervention townships having heard of the Link Up program by the end line. Comparing changes between baseline and end line, a greater proportion of HIV-negative or unknown status YMSM accessed HIV testing in the past 3 months in intervention townships (from 45.0% to 57.1%) compared with those in control townships (remained at 29.0%); however, this difference in the effect over time was not statistically significant in multivariate modeling (adjusted odds ratio: 1.45; 95% confidence interval: .66-3.17). Qualitative findings showed that the intervention

The intersection of antiretroviral therapy, peer support programmes ...

African Journals Online (AJOL)

Evidence suggests that interventions for people living with HIV infection that include, in combination, antiretroviral therapy (ART), peer support and economic empowerment are likely to be more effective than if used alone. We report a qualitative study in West Nile Uganda that explored perceptions of HIV stigma among ...

Building Flexible Manufacturing Systems Based on Peer-Its

Directory of Open Access Journals (Sweden)

dos Santos Rocha M

2008-01-01

Full Text Available Abstract Peer-to-peer computing principles have started to pervade into mechanical control systems, inducing a paradigm shift from centralized to autonomic control. We have developed a self-contained, miniaturized, universal and scalable peer-to-peer based hardware-software system, the peer-it platform, to serve as a stick-on computer solution to raise real-world artefacts like, for example, machines, tools, or appliances towards technology-rich, autonomous, self-induced, and context-aware peers, operating as spontaneously interacting ensembles. The peer-it platform integrates sensor, actuator, and wireless communication facilities on the hardware level, with an object-oriented, component-based coordination framework at the software level, thus providing a generic platform for sensing, computing, controlling, and communication on a large scale. The physical appearance of a peer-it supports pinning it to real-world artefacts, while at the same time integrating those artefacts into a mobile ad hoc network of peers. Peer-it networks thus represent ensembles of coordinated artefacts, exhibiting features of autonomy like self-management at the node level and self-organization at the network level. We demonstrate how the peer-it system implements the desired flexibility in automated manufacturing systems to react in the case of changes, whether intended or unexpectedly occuring. The peer-it system enables machine flexibility in that it adapts production facilities to produce new types of products, or change the order of operation executed on parts instantaneously. Secondly, it enables routing flexibility, that is, the ability to use multiple machines to spontaneously perform the same operation on one part alternatively (to implement autonomic fault tolerance or to absorb large-scale changes in volume, capacity, or capability (to implement autonomic scalability.

Give-and-take based peer-to-peer content distribution networks

Indian Academy of Sciences (India)

Compared to traditional content distribution schemes, peer- to-peer networks ... are shared among users who desire to download files. In a peer-to-peer ..... randomly generated data points, with 300 segments and 200 peers. From the figure ...

Towards a (Decentralization-Based Typology of Peer Production

Directory of Open Access Journals (Sweden)

Melanie Dulong de Rosnay

2016-03-01

Full Text Available Online peer-production platforms facilitate the coordination of creative work and services. Generally considered as empowering participatory tools and a source of common good, they can also be, however, alienating instruments of digital labour. This paper proposes a typology of peer-production platforms, based on the centralization/decentralization levels of several of their design features. Between commons-based peer-production and crowdsourced, user-generated content “enclosed” by corporations, a wide range of models combine different social, political, technical and economic arrangements. This combined analysis of the level of (decentralization of platform features provides information on emancipation capabilities in a more granular way than a market-based qualification of platforms, based on the nature of ownership or business models only. The five selected features of the proposed typology are: ownership of means of production, technical architecture/design, social organization/governance of work patterns, ownership of the peer-produced resource, and value of the output.

Understanding Engagement in HIV Risk and Prevention Research Among Black Young Men Who Have Sex with Men and Transgender Women in the District of Columbia.

Science.gov (United States)

Glick, Sara Nelson; Houston, Ebony; Peterson, James; Kuo, Irene; Magnus, Manya

2016-08-01

To develop optimal methods to study sexual health among black young men who have sex with men and transgender women (BYMSM/TW). We conducted a mixed-methods prospective study to identify recruitment and retention strategies for BYMSM/TW (age 16-21) in Washington D.C., and describe HIV risk behaviors and context. Incentivized peer referral was highly productive, and 60% of BYMSM/TW were retained for 3 months. Participants reported high levels of sexual risk, homophobia, racism, and maternal support. BYMSM/TW studies should utilize a combination of peer-based, in-person, and technology-based recruiting strategies. Additional research is needed to leverage mobile technology and social media to enhance retention.

A comprehensive review of HIV/STI prevention and sexual and reproductive health services among sex Workers in Conflict-Affected Settings: call for an evidence- and rights-based approach in the humanitarian response.

Science.gov (United States)

Ferguson, Alyssa; Shannon, Kate; Butler, Jennifer; Goldenberg, Shira M

2017-01-01

While the conditions in emergency humanitarian and conflict-affected settings often result in significant sex work economies, there is limited information on the social and structural conditions of sex work in these settings, and the impacts on HIV/STI prevention and access to sexual and reproductive health (SRH) services for sex workers. Our objective was to comprehensively review existing evidence on HIV/STI prevention and access to SRH services for sex workers in conflict-affected settings globally. We conducted a comprehensive review of all peer review (both epidemiological and qualitative) and grey literature published in the last 15 years (2000-2015), focusing on 1) HIV/STI vulnerability or prevention, and/or 2) access to SRH services for sex workers in conflict-affected settings. Five databases were searched, using combinations of sex work, conflict/mobility, HIV/STI, and SRH service terms. Relevant peer-reviewed and grey literature were also hand-searched, and key papers were cross-referenced for additional material. Five hundred fifty one records were screened and 416 records reviewed. Of 33 records describing HIV/STI prevention and/or access to SRH services among sex workers in conflict-affected settings, 24 were from sub-Saharan Africa; 18 studies described the results of primary research (13 quantitative, 3 qualitative, 2 mixed-methods) and 15 were non-primary research (e.g., commentaries, policy reports, programmatic manuals). Available evidence indicated that within conflict-affected settings, SWs' capacity to engage in HIV/STI prevention and access SRH services is severely undermined by social and structural determinants including widespread violence and human rights violations, the collapse of livelihoods and traditional social structures, high levels of displacement, and difficulties accessing already scant health services due to stigma, discrimination and criminalization. This review identified significant gaps in HIV/STI and SRH research, policy

Nurse led home-based care for people with HIV/AIDS.

Science.gov (United States)

Wood, Elizabeth M; Zani, Babalwa; Esterhuizen, Tonya M; Young, Taryn

2018-03-27

Home-based care is used in many countries to increase quality of life and limit hospital stay, particularly where public health services are overburdened. Home-based care objectives for HIV/AIDS can include medical care, delivery of antiretroviral treatment and psychosocial support. This review assesses the effects of home-based nursing on morbidity in people infected with HIV/AIDS. The trials studied are in HIV positive adults and children, regardless of sex or setting and all randomised controlled. Home-based care provided by qualified nurses was compared with hospital or health-facility based treatment. The following electronic databases were searched from January 1980 to March 2015: AIDSearch, CINAHL, Cochrane Register of Controlled Trials, EMBASE, MEDLINE and PsycINFO/LIT, with an updated search in November 2016. Two authors independently screened titles and abstracts from the electronic search based on the study design, interventions and types of participant. For all selected abstracts, full text articles were obtained. The final study selection was determined with use of an eligibility form. Data extraction was performed independently from assessment of risk of bias. The results were analysed by narrative synthesis, in order to be able to obtain relevant effect measures plus 95% confidence intervals. Seven studies met the inclusion criteria. The trial size varied from 37 to 238 participants. Only one trial was conducted in children. Five studies were conducted in the USA and two in China. Four studies looked at home-based adherence support and the rest at providing home-based psychosocial support. Reported adherence to antiretroviral drugs improved with nurse-led home-based care but did not affect viral load. Psychiatric nurse support in those with existing mental health conditions improved mental health and depressive symptoms. Home-based psychological support impacted on HIV stigma, worry and physical functioning and in certain cases depressive symptoms

Factors Associated with Recent HIV Testing among Heterosexuals at High-Risk for HIV Infection in New York City

Directory of Open Access Journals (Sweden)

Marya eGwadz

2016-04-01

Full Text Available Background. The CDC recommends persons at high-risk for HIV infection in the United States receive annual HIV testing to foster early HIV diagnosis and timely linkage to health care. Heterosexuals make up a significant proportion of incident HIV infections (>25%, but test for HIV less frequently than those in other risk categories. Yet factors that promote or impede annual HIV testing among heterosexuals are poorly understood. The present study examines individual/attitudinal-, social-, and structural-level factors associated with past-year HIV testing among heterosexuals at high-risk for HIV. Methods. Participants were African American/Black and Hispanic heterosexual adults (N=2307 residing in an urban area with both high poverty and HIV prevalence rates. Participants were recruited by respondent-driven sampling (RDS in 2012-2015 and completed a computerized structured assessment battery covering background factors, multi-level putative facilitators of HIV testing, and HIV testing history. Separate logistic regression analysis for males and females identified factors associated with past-year HIV testing.Results. Participants were mostly male (58%, African American/Black (75%, and 39 years old on average (SD = 12.06 years. Lifetime homelessness (54% and incarceration (62% were common. Half reported past-year HIV testing (50% and 37% engaged in regular, annual HIV testing. Facilitators of HIV testing common to both genders included sexually transmitted infection (STI testing or STI diagnosis, peer norms supporting HIV testing, and HIV testing access. Among women, access to general medical care and extreme poverty further predicted HIV testing, while recent drug use reduced the odds of past-year HIV testing. Among men, past-year HIV testing was also associated with lifetime incarceration and substance use treatment.Conclusions. The present study identified gaps in rates of HIV testing among heterosexuals at high-risk for HIV, and both common and

Cooperative peer-to-peer multiagent-based systems.

Science.gov (United States)

Caram, L F; Caiafa, C F; Ausloos, M; Proto, A N

2015-08-01

A multiagent based model for a system of cooperative agents aiming at growth is proposed. This is based on a set of generalized Verhulst-Lotka-Volterra differential equations. In this study, strong cooperation is allowed among agents having similar sizes, and weak cooperation if agents have markedly different "sizes", thus establishing a peer-to-peer modulated interaction scheme. A rigorous analysis of the stable configurations is presented first examining the fixed points of the system, next determining their stability as a function of the model parameters. It is found that the agents are self-organizing into clusters. Furthermore, it is demonstrated that, depending on parameter values, multiple stable configurations can coexist. It occurs that only one of them always emerges with probability close to one, because its associated attractor dominates over the rest. This is shown through numerical integrations and simulations, after analytic developments. In contrast to the competitive case, agents are able to increase their capacity beyond the no-interaction case limit. In other words, when some collaborative partnership among a relatively small number of partners takes place, all agents act in good faith prioritizing the common good, when receiving a mutual benefit allowing them to surpass their capacity.

Sustained impact of inattention and hyperactivity-impulsivity on peer problems: mediating roles of prosocial skills and conduct problems in a community sample of children.

Science.gov (United States)

Andrade, Brendan F; Tannock, Rosemary

2014-06-01

This prospective 2-year longitudinal study tested whether inattentive and hyperactive/impulsive symptom dimensions predicted future peer problems, when accounting for concurrent conduct problems and prosocial skills. A community sample of 492 children (49 % female) who ranged in age from 6 to 10 years (M = 8.6, SD = .93) was recruited. Teacher reports of children's inattention, and hyperactivity/impulsivity symptoms, conduct problems, prosocial skills and peer problems were collected in two consecutive school years. Elevated inattention and hyperactivity/impulsivity in Year-1 predicted greater peer problems in Year-2. Conduct problems in the first and second years of the study were associated with more peer problems, and explained a portion of the relationship between inattention and hyperactivity/impulsivity with peer problems. However, prosocial skills were associated with fewer peer problems in children with elevated inattention and hyperactivity/impulsivity. Inattention and hyperactivity/impulsivity have negative effects on children's peer functioning after 1-year, but concurrent conduct problems and prosocial skills have important and opposing impacts on these associations.

Home-based voluntary HIV counselling and testing found highly acceptable and to reduce inequalities

Directory of Open Access Journals (Sweden)

Michelo Charles

2010-06-01

Full Text Available Abstract Background Low uptake of voluntary HIV counselling and testing (VCT in sub-Saharan Africa is raising acceptability concerns which might be associated with ways by which it is offered. We investigated the acceptability of home-based delivery of counselling and HIV testing in urban and rural populations in Zambia where VCT has been offered mostly from local clinics. Methods A population-based HIV survey was conducted in selected communities in 2003 (n = 5035. All participants stating willingness to be HIV tested were offered VCT at home and all counselling was conducted in the participants' homes. In the urban area post-test counselling and giving of results were done the following day whereas in rural areas this could take 1-3 weeks. Results Of those who indicated willingness to be HIV tested, 76.1% (95%CI 74.9-77.2 were counselled and received the test result. Overall, there was an increase in the proportion ever HIV tested from 18% before provision of home-based VCT to 38% after. The highest increase was in rural areas; among young rural men aged 15-24 years up from 14% to 42% vs. for urban men from 17% to 37%. Test rates by educational attainment changed from being positively associated to be evenly distributed after home-based VCT. Conclusions A high uptake was achieved by delivering HIV counselling and testing at home. The highest uptakes were seen in rural areas, in young people and groups with low educational attainment, resulting in substantial reductions in existing inequalities in accessing VCT services.

Determinants of HIV/AIDS in armed conflict populations.

Science.gov (United States)

Omare, Danvas; Kanekar, Amar

2011-03-01

More than 40 million people worldwide have been infected with human immunodeficiency virus (HIV) since it was first reported in 1981. Over 25 million of these have lost their lives to the disease. Most of the studies related to HIV/AIDS have been conducted in stable populations across the globe. Few of these studies have been devoted to displaced populations, particularly those in areas of conflict. Displaced populations that are forced to leave their homes in most cases find themselves in unfamiliar territories, often poor and hungry. Many of them become refugees and internally displaced people (IDPs). The objective of this review was to address a number of different social determinants of HIV/AIDS in displaced populations in areas of conflict. A comprehensive review of peer reviewed literature published in English between 1990 and 2010 obtained through an open search of PUBMED database using key words such as HIV and war , HIV/AIDS and conflict , AIDS and security was conducted. Twelve different studies that looked at the implications of HIV/AIDS in conflict or displaced populations were retrieved. The review revealed that there were various factors influencing conflict and HIV/AIDS such as forced population displacement, breakdown of traditional sexual norms, lack of health infrastructure, and poverty and powerlessness of women and children. Social determinants of increased HIV/AIDS prevalence in displaced populations are scarcity of food, poverty, insecurity of displaced populations and gender power differentials.

Determinants of HIV/AIDS in armed conflict populations

Directory of Open Access Journals (Sweden)

Danvas Omare

2011-02-01

Full Text Available More than 40 million people worldwide have been infected with human immunodeficiency virus (HIV since it was first reported in 1981. Over 25 million of these have lost their lives to the disease. Most of the studies related to HIV/AIDS have been conducted in stable populations across the globe. Few of these studies have been devoted to displaced populations, particularly those in areas of conflict. Displaced populations that are forced to leave their homes in most cases find themselves in unfamiliar territories, often poor and hungry. Many of them become refugees and internally displaced people (IDPs. The objective of this review was to address a number of different social determinants of HIV/AIDS in displaced populations in areas of conflict. A comprehensive review of peer reviewed literature published in English between 1990 and 2010 obtained through an open search of PUBMED database using key words such as “HIV and war”, “HIV/AIDS and conflict”, “AIDS and security” was conducted. Twelve different studies that looked at the implications of HIV/AIDS in conflict or displaced populations were retrieved. The review revealed that there were various factors influencing conflict and HIV/AIDS such as forced population displacement, breakdown of traditional sexual norms, lack of health infrastructure, and poverty and powerlessness of women and children. Social determinants of increased HIV/AIDS prevalence in displaced populations are scarcity of food, poverty, insecurity of displaced populations and gender power differentials.

Evolution of HIV and AIDS Programmes in an African Institution of Higher Learning: The Case of the Copperbelt University in Zambia

Science.gov (United States)

Sanjobo, Nawa; Lukwesa, Matilda; Kaziya, Charity; Tepa, Cornwell; Puta, Bernard

2016-01-01

Background: Universities present the foundation for socio-economic and political development. Without structures and processes to fight HIV, there is no prospect of enhancing treatment, prevention, care and support services. Copperbelt University HIV and AIDS response was initiated in 2003 with the aim of building capacity of students and employees in HIV and AIDS. Objectives: The main objective of this paper is to demonstrate how the CBU HIV response has evolved over time and provide a timeline of important milestones in the development process. Method: Peer educators and counsellors conduct sensitization campaigns through one on one discussion, workshops, and drama performances, distribution of Information, Education and Communication (IEC) materials. Results: HIV Programme has been set up with players from policy, programme and community levels. Strategic processes, collaborations, funding, medical insurance schemes, prevention, treatment, care and support services, training of peer educators and counsellors have been established. Conclusion: Copperbelt University HIV initiative has demonstrated potential to reduce new infections in the university, and is currently expanding her programme to encompass wellness and also spearhead the integration of HIV in the university curriculum. PMID:27347269

Evolution of HIV and AIDS Programmes in an African Institution of Higher Learning: The Case of the Copperbelt University in Zambia.

Science.gov (United States)

Sanjobo, Nawa; Lukwesa, Matilda; Kaziya, Charity; Tepa, Cornwell; Puta, Bernard

2016-01-01

Universities present the foundation for socio-economic and political development. Without structures and processes to fight HIV, there is no prospect of enhancing treatment, prevention, care and support services. Copperbelt University HIV and AIDS response was initiated in 2003 with the aim of building capacity of students and employees in HIV and AIDS. The main objective of this paper is to demonstrate how the CBU HIV response has evolved over time and provide a timeline of important milestones in the development process. Peer educators and counsellors conduct sensitization campaigns through one on one discussion, workshops, and drama performances, distribution of Information, Education and Communication (IEC) materials. HIV Programme has been set up with players from policy, programme and community levels. Strategic processes, collaborations, funding, medical insurance schemes, prevention, treatment, care and support services, training of peer educators and counsellors have been established. Copperbelt University HIV initiative has demonstrated potential to reduce new infections in the university, and is currently expanding her programme to encompass wellness and also spearhead the integration of HIV in the university curriculum.

Prediction of Risk Behaviors in HIV-infected Patients Based on Family Functioning: The Mediating Roles of Lifestyle and Risky Decision Making

Directory of Open Access Journals (Sweden)

Fariba Ebrahim Babaei

2017-09-01

Full Text Available Background and Objective: Risk behaviors are more common in the HIV-positive patients than that in the general population. These behaviors are affected by various factors, such as biological, familial, and social determinants, peer group, media, and lifestyle. Low family functioning is one of the important factors predicting risk behaviors. Regarding this, the present study aimed to investigate the role of family functioning in predicting risk behaviors in the HIV-infected patients based on the mediating roles of risky decision making and lifestyle. Materials and Methods: This descriptive correlational study was conducted on 147 HIV-positive patients selected through convenience sampling technique. The data were collected using the health promoting lifestyle profile-2 (HPLP-2, family adaptability and cohesion scale IV (FACES-IV, balloon analogue risk task (BART, and risk behavior assessment in social situation. The data were analyzed using structural equation modeling method in LISREL 8.8 software. Results: According to the results, there was an indirect relationship between family functioning and risk behaviors. Furthermore, family functioning both directly and indirectly affected the risk behaviors through two mediators of lifestyle and risky decision making. Conclusion: As the findings indicated, family functioning directly contributed to risk behaviors. Moreover, this variable indirectly affected risk behaviors through the mediating roles of risky decision making and lifestyle. Consequently, the future studies should focus more deeply on family functioning role in the risk behaviors of the HIV-infected patients.

HIV/AIDS Knowledge, Self-Efficacy for Limiting Sexual Risk Behavior and Parental Monitoring.

Science.gov (United States)

Mahat, Ganga; Scoloveno, Mary Ann; Scoloveno, Robert

2016-01-01

The purpose of this study was to explore HIV/AIDS knowledge, self-efficacy for sexual risk behaviors, and parental monitoring in a sample of 140 7th and 9th grade adolescents studying in an urban high school in the United States. Further, the study examined differences in HIV/AIDS knowledge, self-efficacy and parental monitoring by grade and gender. This study also investigated the effectiveness of an HIV/AIDS peer education program, Teens for AIDS Prevention (TAP), on improving adolescents' HIV/AIDS knowledge. A quasi-experimental design was used to examine effects of the peer education program (TAP) on adolescents' HIV/AIDS knowledge. Pearson-product-moment correlation coefficients were calculated to examine the relationships among the variables. Independent t-tests were used to compare adolescents' HIV/AIDS knowledge, self-efficacy, and parental monitoring scores by grade and gender. Paired t-tests were used to determine differences in pre-intervention and post-intervention HIV/AIDS knowledge. The results showed that HIV/AIDS knowledge improved significantly in both 7th and 9th grade students after the intervention. HIV/AIDS knowledge was associated with self-efficacy; however it was not associated with parental monitoring. There were no significant differences in HIV/AIDS knowledge and self-efficacy by gender. However, there was a significant difference in parental monitoring by gender. Pediatric nurses are well-positioned to develop and implement evidence-based programs for adolescents. It is essential that pediatric nurses, in conjunction with other professionals and parent groups, take the initiative in implementing peer education programs in schools and community centers to promote healthy behaviors among adolescents. Copyright © 2016 Elsevier Inc. All rights reserved.

Awareness, discussion and non-prescribed use of HIV pre-exposure prophylaxis among persons living with HIV/AIDS in Italy: a Nationwide, cross-sectional study among patients on antiretrovirals and their treating HIV physicians.

Science.gov (United States)

Palummieri, Antonio; De Carli, Gabriella; Rosenthal, Éric; Cacoub, Patrice; Mussini, Cristina; Puro, Vincenzo

2017-11-28

Before Pre-Exposure Prophylaxis (PrEP) was officially recommended and made available, a few surveys among gay and bisexual men, and persons living with HIV/AIDS (PLWHA), identified an informal use of antiretrovirals (ARVs) for PrEP among HIV-negative individuals. Before PrEP availability in Italy, we aimed to assess whether PLWHA in Italy shared their ARVs with HIV-negative individuals, whether they knew people who were on PrEP, and describe the level of awareness and discussion on this preventive measure among them and people in their close circle. Two anonymous questionnaires investigating personal characteristics and PrEP awareness, knowledge, and experience were proposed to HIV specialists and their patients on ARVs in a one-week, cross-sectional survey (December 2013-January 2014). Among PLWHA, a Multivariable Logistic Regression analysis was conducted to identify factors associated with PrEP discussion with peers (close circle and/or HIV associations), and experience (use in close circle and/or personal ARV sharing). Eighty-seven specialists in 31 representative Infectious Diseases departments administered the questionnaire to 1405 PLWHA. Among specialists, 98% reported awareness, 65% knew the dosage schedule, and 14% had previously suggested or prescribed PrEP. Among PLWHA, 45.6% were somehow aware, discussed or had direct or indirect experience of PrEP: 38% "had heard" of PrEP, 24% were aware of studies in HIV-negative individuals demonstrating a risk reduction through the use of ARVs, 22% had discussed PrEP, 12% with peers; 9% reported PrEP use in close circle and 1% personal ARV sharing. Factors predictive of either PrEP discussion with peers or experience differed between men and women, but across all genders were mainly related to having access to information, with HIV association membership being the strongest predictor. At a time and place where there were neither official information nor proposals or interventions to guide public policies on PrEP in

Factors influencing social self-disclosure among adolescents living with HIV in Eastern Africa

OpenAIRE

N?stlinger, Christiana; Bakeera-Kitaka, Sabrina; Buyze, Jozefien; Loos, Jasna; Buv?, Anne

2015-01-01

Adolescents living with HIV (ALHIV) face many psychosocial challenges, including HIV disclosure to others. Given the importance of socialization during the adolescent transition process, this study investigated the psychological and social factors influencing self-disclosure of own HIV status to peers. We examined social HIV self-disclosure to peers, and its relationship to perceived HIV-related stigma, self-efficacy to disclose, self-esteem, and social support among a sample of n = 582 ALHIV...

How peer conversations about HIV/AIDS media messages affect ...

African Journals Online (AJOL)

Most existent research on the effects of interpersonal discussions about health campaign messages is based on surveys. In this study, we analysed actual conversations about an HIV/AIDS poster to find out possible effects. Young South African women in 59 dyads (n = 118) participated in conversations about a deliberately ...

Building a Conceptual Framework to Study the Effect of HIV Stigma-Reduction Intervention Strategies on HIV Test Uptake: A Scoping Review.

Science.gov (United States)

Thapa, Subash; Hannes, Karin; Cargo, Margaret; Buve, Anne; Aro, Arja R; Mathei, Catharina

A scoping review of grey and peer-reviewed literature was conducted to develop a conceptual framework to illustrate mechanisms involved in reducing HIV stigma and increasing HIV test uptake. We followed a three-step approach to exploring the literature: developing concepts, organizing and categorizing concepts, and synthesizing concepts into a framework. The framework contains four types of intervention strategies: awareness creation, influencing normative behavior, providing support, and developing regulatory laws. The awareness creation strategy generally improves knowledge and the influencing normative behavior strategy changes stigmatizing attitudes and behaviors, and subsequently, increases HIV test uptake. Providing support and development of regulatory law strategies changes actual stigmatizing behaviors of the people, and subsequently, increases HIV test uptake. The framework further outlines that the mechanisms described are influenced by the interaction of various social-contextual and individual factors. The framework sheds new light on the effects of HIV stigma-reduction intervention strategies and HIV test uptake. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Development of an epitope-based HIV-1 vaccine strategy from HIV-1 lipopeptide to dendritic-based vaccines.

Science.gov (United States)

Surenaud, Mathieu; Lacabaratz, Christine; Zurawski, Gérard; Lévy, Yves; Lelièvre, Jean-Daniel

2017-10-01

Development of a safe, effective and globally affordable Human Immunodeficiency Virus strain 1 (HIV-1) vaccine offers the best hope for future control of the HIV-1 pandemic. However, with the exception of the recent RV144 trial, which elicited a modest level of protection against infection, no vaccine candidate has shown efficacy in preventing HIV-1 infection or in controlling virus replication in humans. There is also a great need for a successful immunotherapeutic vaccine since combination antiretroviral therapy (cART) does not eliminate the reservoir of HIV-infected cells. But to date, no vaccine candidate has proven to significantly alter the natural history of an individual with HIV-1 infection. Areas covered: For over 25 years, the ANRS (France Recherche Nord&Sud Sida-HIV hépatites) has been committed to an original program combining basic science and clinical research developing an epitope-based vaccine strategy to induce a multiepitopic cellular response against HIV-1. This review describes the evolution of concepts, based on strategies using HIV-1 lipopeptides towards the use of dendritic cell (DC) manipulation. Expert commentary: Understanding the crucial role of DCs in immune responses allowed moving from the non-specific administration of HIV-1 sequences with lipopeptides to DC-based vaccines. These DC-targeting strategies should improve HIV-1 vaccine efficacy.

The development of a multidisciplinary, evidence-based guideline for "HIV and employment".

Science.gov (United States)

Wagener, Marlies N; Roelofs, Pepijin; Miedema, Harold S; Brandjes, Dees P M; Dahmen, Rutger; van Gorp, Eric C M

2015-01-01

The objective of this study was to develop a multidisciplinary guideline that supports the care and vocational rehabilitation of HIV-infected people with employment-related problems. The guideline was developed according to the "evidence-based guideline development" method developed by the Dutch Institute for Health Care Improvement. This method consists of the following steps: forming a multidisciplinary core group and an expert panel, formulating key questions, searching and appraising the available literature, formulating considerations and recommendations, peer reviewing the draft guideline, and authorizing the final guideline. All relevant professional associations were represented in the core group that was assembled to develop the guideline, i.e., HIV doctors, HIV nurses, general practitioners, occupational health physicians, psychologists, social workers, occupational health nurses, vocational experts, and insurance physicians. Five key questions for the guideline were formulated with the following themes: determinants of employment, disclosure and stigma, self-management, interventions, and the organization of care. In the literature review on these topics, 45 studies met the inclusion criteria. The methodological quality of the included articles was poor. Factors such as patient preferences and medical/ethical issues were considered. The recommendations in the guideline are a weighting of the scientific evidence and the considerations of the core group. The guideline, as well as its summary for daily practice, clarifies the most important barriers and facilitators to people with HIV either staying at work or returning to work, and it constitutes a clinical, easy-to-use guideline for health-care providers and how they can support people with HIV who want to work.

Web and Mobile Based HIV Prevention and Intervention Programs Pros and Cons - A Review.

Science.gov (United States)

Niakan, Sharareh; Mehraeen, Esmaeil; Noori, Tayebeh; Gozali, Elahe

2017-01-01

With the increasing growth of HIV positive people the use of information and communication technologies (ICT) can play an important role in controlling the spread of the AIDS. Web and Mobile are the new technologies that young people take advantage from them. In this study a review to investigate the web and mobile based HIV prevention and intervention programs was carried out. A scoping review was conducted including PubMed, Science direct, Web of Science and Proquest to find relevant sources that published in 2009 to 2016. To identify published, original research that reported the web and mobile-based HIV prevention and intervention programs, an organized search was conducted with the following search keywords in combination: HIV, AIDS, m-Health, Mobile phone, Cell phone, Smartphone, Mobile health, internet, and web. Using the employed strategies, 173 references retrieved. Searched articles were compared based on their titles and abstracts. To identify duplicated articles, the title and abstracts were considered and 101 duplicated references were excluded. By going through the full text of related papers, 35 articles were found to be more related to the questions of this paper from which 72 final included. The advantages of web and mobile-based interventions include the possibility to provide constancy in the delivery of an intervention, impending low cost, and the ability to spread the intervention to an extensive community. Online programs such as Chat room-based Education program, Web-based therapeutic education system, and Online seek information can use for HIV/AIDS prevention. To use of mobile for HIV/AIDS prevention and intervention, programs including in: Health system focused applications, Population health focused applications, and Health messaging can be used.

The Simalelo Peer Education Programme for HIV prevention: a ...

African Journals Online (AJOL)

The aim of the project was to evaluate a peer education programme in Zambia run by local people in relation to changes in behaviours, the effects of the programme on the community and the dynamics of peer health promotion. A qualitative process evaluation using focus groups consisting of both participants in the peer ...

Understanding the experience and manifestation of depression in adolescents living with HIV in Harare, Zimbabwe

Science.gov (United States)

Mavhu, Webster; Wogrin, Carol; Mutsinze, Abigail; Kagee, Ashraf

2018-01-01

Background Studies have found that adolescents living with HIV are at risk of depression, which in turn affects adherence to medication. This study explored the experience and manifestation of depression in adolescents living with HIV in Zimbabwe in order to inform intervention development. Methods We conducted a body mapping exercise with 21 HIV positive 15–19 years olds who had been diagnosed with major depressive disorder. Participants created a painted map of their body to assist them in expressing their somatic and emotional experiences in qualitative interviews. The interviews were transcribed and thematically coded using NVivo 10. Results Participants attributed their experiences of depression to their relationships and interactions with significant people in their lives, primarily family members and peers. A sense of being different from others was common among participants, both due to their HIV status and the impact HIV has had on their life circumstances. Participants described a longing to be important or to matter to the people in their lives. A sense of isolation and rejection was common, as well as grief and loss, including ambiguous and anticipated loss. Participants’ idioms of distress included ‘thinking deeply’ (‘kufungisisa’), ‘pain’, darkness, ‘stress’ or a lack of hope and ambiguity for the future. Suicidal ideation was described, including slow suicide through poor adherence. Supportive factors were also relational, including the importance of supportive relatives and peers, clinic staff and psychosocial support programmes. Conclusions An understanding of HIV positive adolescents’ own narratives around depression can inform the development and integration of appropriate mental health interventions within HIV care and treatment programmes. Study findings suggest that family and peer-led interventions are potentially useful in the prevention and management of depression in adolescents living with HIV. PMID:29298326

"Now That I'm Pregnant, I'm No Longer an Example": Peer Educator Experiences of an HIV Prevention Programme in Cape Town, South Africa

Science.gov (United States)

Wolf, Kimberly; Africa, Adelene

2017-01-01

Despite the popularity of peer education as an HIV prevention strategy across a range of contexts, understanding of the experiences of those intimately placed within these programmes is limited. Instead, the majority of research in this field relies on hegemonic notions of rational human behaviour that operate under the assumption that knowledge…

Engaging community to support HIV prevention research.

Science.gov (United States)

Sahay, Seema; Mehendale, Sanjay

2011-01-01

Actively engaging communities in effective partnerships is considered critical for ethically robust and locally relevant HIV prevention research. This can be challenging in developing countries that have little prior experience in this area. This paper summarizes processes and lessons learnt while setting up the Community Involvement Plan of National AIDS Research Institute, Pune, India. Formal partnerships were established with voluntary agencies. The focus was on using strategies adapted from participatory learning and action techniques. The community program was implemented through peer educators specifically identified from the communities where partner non-governmental organizations function. At the grass root level, peer educators imparted education to the common people about research studies and helped to implement community based recruitment and retention activities. The focus was on facilitating periodic interaction between the outreach workers of the research team and the peers and modifying the strategies till they were found locally implementable and appropriate. Through adequate time investment, mutually beneficial and respectful partnerships with community based organizations and grass root level workers, the community became actively involved in clinical research. The program helped in developing a sense of partnership among the peers for the research conducted by the research organization, widening the net of community education and identification of research participants. By building trust in the community and implementing research within an ethical framework, culturally sensitive matters were appropriately addressed. The community involvement process is long, laborious and ever-evolving. Effective community engagement requires institutional leadership support, adequate funding and commitment by researchers. It is possible to sustain such a model in a resource limited setting.

African American church-based HIV testing and linkage to care: assets, challenges and needs.

Science.gov (United States)

Stewart, Jennifer M; Thompson, Keitra; Rogers, Christopher

2016-01-01

The US National HIV AIDS strategy promotes the use of faith communities to lessen the burden of HIV in African American communities. One specific strategy presented is the use of these non-traditional venues for HIV testing and co-location of services. African American churches can be at the forefront of this endeavour through the provision of HIV testing and linkage to care. However, there are few interventions to promote the churches' involvement in both HIV testing and linkage to care. We conducted 4 focus groups (n = 39 participants), 4 interviews and 116 surveys in a mixed-methods study to examine the feasibility of a church-based HIV testing and linkage to care intervention in Philadelphia, PA, USA. Our objectives were to examine: (1) available assets, (2) challenges and barriers and (3) needs associated with church-based HIV testing and linkage to care. Analyses revealed several factors of importance, including the role of the church as an access point for testing in low-income neighbourhoods, challenges in openly discussing the relationship between sexuality and HIV, and buy-in among church leadership. These findings can support intervention development and necessitate situating African American church-based HIV testing and linkage to care interventions within a multi-level framework.

Exploring Treatment Needs and Expectations for People Living with HIV in South Africa: A Qualitative Study.

Science.gov (United States)

Earnshaw, Valerie A; Bogart, Laura M; Courtney, Ingrid; Zanoni, Holly; Bangsberg, David R; Orrell, Catherine; Goggin, Kathy; Katz, Ingrid T

2018-04-04

The UNAIDS 90-90-90 treatment targets aim to dramatically increase the number of people who initiate antiretroviral therapy (ART) by 2020. Greater understanding of barriers to ART initiation in high prevalence countries like South Africa is critical. Qualitative semi-structured interviews were conducted with 30 participants in Gugulethu Township, South Africa, including 10 healthcare providers and 20 people living with HIV (PLWH) who did not initiate ART. Interviews explored barriers to ART initiation and acceptability of theory-based intervention strategies to optimize ART initiation. An inductive content analytic approach was applied to the data. Consistent with the Theory of Triadic Influence, barriers to ART initiation were identified at the individual, social, and structural levels. Results suggested high acceptability for intervention strategies involving trained HIV-positive peers among South African PLWH and healthcare providers. Research is needed to evaluate their feasibility and efficacy in high HIV prevalence countries.

HIV incidence in sub-Saharan Africa: a review of available data with implications for surveillance and prevention planning.

Science.gov (United States)

Braunstein, Sarah L; van de Wijgert, Janneke H H M; Nash, Denis

2009-01-01

HIV incidence estimation is increasingly being incorporated into HIV/AIDS surveillance activities in both resource-rich and developing countries. We conducted a systematic review to assess the availability of HIV incidence data from sub-Saharan Africa. We examined peer-reviewed articles, conference proceedings and technical reports published from 1987-2008. Incidence estimates were classified by country, year, population group, and estimation method (prospective study or the serologic testing algorithm for recent HIV seroconversion; STARHS). Our search yielded HIV incidence estimates for 15 of 44 sub-Saharan African countries, with 57 studies generating 264 unique estimates. Of these, 239 (91%) were obtained via prospective studies, and 25 (9%) via the STARHS method (24 using the BED-CEIA assay). Only five countries reported population-based estimates, and less than two-thirds of studies reported risk factor information. STARHS use increased over time, comprising 20% of estimates since 2006. However, studies that compared STARHS estimates with prospectively observed or modeled estimates often found substantial levels of disagreement, with STARHS often overestimating HIV incidence. Population-based HIV incidence estimates and risk factor information in sub-Saharan Africa remain scant but increasingly available. Regional STARHS data suggest a need for further validation prior to widespread use and incorporation into routine surveillance activities. In the meantime, prevalence and behavioral risk factor data remain important for HIV prevention planning.

HIV incidence from the first population-based cohort study in India.

Science.gov (United States)

Dandona, Lalit; Kumar, G Anil; Lakshmi, Vemu; Ahmed, G Md Mushtaq; Akbar, Mohammed; Ramgopal, Sri P; Sudha, Talasila; Alary, Michel; Dandona, Rakhi

2013-07-17

Understanding about who acquires new HIV infection and the determinants of why some persons get infected and others do not is fundamental to controlling HIV in the population. We assess HIV incidence and its associations in the population of a high HIV burden district in Andhra Pradesh state in southern India by a population-based longitudinal cohort study. We re-surveyed a population-based cohort of 12,617 adults in Guntur district of Andhra Pradesh for which we had reported a baseline HIV prevalence of 1.72% (rural 1.64%, urban 1.89%) among the 15-49 years age group in 2004-2005. We conducted interviews to assess risk behaviour and performed HIV testing again in 2010-2011. We assessed the rate of new HIV infection and its associations using multiple logistic regression. The participation rate in the follow-up was 74.9% and 63.9% of the baseline rural and urban samples, respectively. Over a mean follow-up of 5.63 years, the incidence of HIV was 1.26 per 1000 person-years (95% CI 0.83-1.69), after adjusting for slight compositional bias in the follow-up sample. The incidence per 1000 person-years was higher among rural men (1.68) than urban men (0.85), and among rural women (1.28) than urban women (0.54). The strongest association with incidence was a HIV positive spouse in the baseline for both men (odds ratio 266, 95% CI 62-1137) and women (odds ratio 28, 95% CI 9-88). Among men the other significant associations with HIV incidence were frequent use of condom for sex over the past 6 months, non-circumcision, more than one lifetime woman sex partner or ever visited sex worker, and transport-related occupation; for women the other significant associations were having had HIV testing other than antenatal check-up, previously married but currently not, and tobacco use. These first population-based cohort incidence data from India suggest that rural areas of high HIV burden states would need more attention to prevent new HIV infections, and that spouses of HIV

Sex workers perspectives on strategies to reduce sexual exploitation and HIV risk: a qualitative study in Tijuana, Mexico.

Science.gov (United States)

Goldenberg, Shira M; Engstrom, David; Rolon, Maria Luisa; Silverman, Jay G; Strathdee, Steffanie A

2013-01-01

Globally, female sex workers are a population at greatly elevated risk of HIV infection, and the reasons for and context of sex industry involvement have key implications for HIV risk and prevention. Evidence suggests that experiences of sexual exploitation (i.e., forced/coerced sex exchange) contribute to health-related harms. However, public health interventions that address HIV vulnerability and sexual exploitation are lacking. Therefore, the objective of this study was to elicit recommendations for interventions to prevent sexual exploitation and reduce HIV risk from current female sex workers with a history of sexual exploitation or youth sex work. From 2010-2011, we conducted in-depth interviews with sex workers (n = 31) in Tijuana, Mexico who reported having previously experienced sexual exploitation or youth sex work. Participants recommended that interventions aim to (1) reduce susceptibility to sexual exploitation by providing social support and peer-based education; (2) mitigate harms by improving access to HIV prevention resources and psychological support, and reducing gender-based violence; and (3) provide opportunities to exit the sex industry via vocational supports and improved access to effective drug treatment. Structural interventions incorporating these strategies are recommended to reduce susceptibility to sexual exploitation and enhance capacities to prevent HIV infection among marginalized women and girls in Mexico and across international settings.

Effects That Facebook-Based Online Peer Assessment with Micro-Teaching Videos Can Have on Attitudes toward Peer Assessment and Perceived Learning from Peer Assessment

Science.gov (United States)

Lin, Guan-Yu

2016-01-01

The present study investigates the effects that Facebook-based online peer assessment with micro-teaching videos can have on attitudes toward peer assessment and perceived learning from peer assessment. The study recruited a sample of 31 university students who were enrolled in a teacher-training course. Using assessees' microteaching videos, the…

Caring for caregivers of people living with HIV in the family: a response to the HIV pandemic from two urban slum communities in Pune, India.

Science.gov (United States)

Kohli, Rewa; Purohit, Vidula; Karve, Latika; Bhalerao, Vinod; Karvande, Shilpa; Rangan, Sheela; Reddy, Srikanth; Paranjape, Ramesh; Sahay, Seema

2012-01-01

In low resource settings, the vast majority of 'Person/people Living with HIV' (PLHIV/s) and inadequate healthcare delivery systems to meet their treatment and care needs, caregivers play a vital role. Home based caregivers are often unrecognized with limited AIDS policies and programs focusing on them. We explored the perceptions and norms regarding care being provided by family caregivers of PLHIVs in India. A community based qualitative study to understand the issues pertaining to home based care for PLHIV was conducted in urban settings of Pune city, in Maharashtra, India. Eight Focus Group Discussions (FGDs) among men, women and peer educators were carried out. A total of 44 in-depth Interviews (IDIs) with PLHIVs (20) and their caregivers (24), were conducted using separate guides respectively. Data was analyzed thematically. Home based care was perceived as economically viable option available for PLHIVs. 'Care' comprised of emotional, adherence, nursing and financial support to PLHIV. Home based care was preferred over hospital based care as it ensured confidentiality and patient care without hampering routine work at home. Women emerged as more vital primary caregivers compared to men. Home based care for men was almost unconditional while women had no such support. The natal family of women also abandoned. Their marital families seemed to provide support. Caregivers voiced the need for respite care and training. Gender related stigma and discrimination existed irrespective of women being the primary family caregivers. The support from marital families indicates a need to explore care and support issues at natal and marital homes of the women living with HIV respectively. Home based care training and respite care for the caregivers is recommended. Gender sensitive interventions addressing gender inequity and HIV related stigma should be modeled while designing interventions for PLHIVs and their family caregivers.

Caring for caregivers of people living with HIV in the family: a response to the HIV pandemic from two urban slum communities in Pune, India.

Directory of Open Access Journals (Sweden)

Rewa Kohli

Full Text Available INTRODUCTION: In low resource settings, the vast majority of 'Person/people Living with HIV' (PLHIV/s and inadequate healthcare delivery systems to meet their treatment and care needs, caregivers play a vital role. Home based caregivers are often unrecognized with limited AIDS policies and programs focusing on them. We explored the perceptions and norms regarding care being provided by family caregivers of PLHIVs in India. METHODOLOGY: A community based qualitative study to understand the issues pertaining to home based care for PLHIV was conducted in urban settings of Pune city, in Maharashtra, India. Eight Focus Group Discussions (FGDs among men, women and peer educators were carried out. A total of 44 in-depth Interviews (IDIs with PLHIVs (20 and their caregivers (24, were conducted using separate guides respectively. Data was analyzed thematically. RESULTS: Home based care was perceived as economically viable option available for PLHIVs. 'Care' comprised of emotional, adherence, nursing and financial support to PLHIV. Home based care was preferred over hospital based care as it ensured confidentiality and patient care without hampering routine work at home. Women emerged as more vital primary caregivers compared to men. Home based care for men was almost unconditional while women had no such support. The natal family of women also abandoned. Their marital families seemed to provide support. Caregivers voiced the need for respite care and training. DISCUSSION: Gender related stigma and discrimination existed irrespective of women being the primary family caregivers. The support from marital families indicates a need to explore care and support issues at natal and marital homes of the women living with HIV respectively. Home based care training and respite care for the caregivers is recommended. Gender sensitive interventions addressing gender inequity and HIV related stigma should be modeled while designing interventions for PLHIVs and their

Coalition-based multimedia peer matching strategies for P2P networks

Science.gov (United States)

Park, Hyunggon; van der Schaar, Mihaela

2008-01-01

In this paper, we consider the problem of matching users for multimedia transmission in peer-to-peer (P2P) networks and identify strategies for fair resource division among the matched multimedia peers. We propose a framework for coalition formation, which enables users to form a group of matched peers where they can interact cooperatively and negotiate resources based on their satisfaction with the coalition, determined by explicitly considering the peer's multimedia attributes. In addition, our proposed approach goes a step further by introducing the concept of marginal contribution, which is the value improvement of the coalition induced by an incoming peer. We show that the best way for a peer to select a coalition is to choose the coalition that provides the largest division of marginal contribution given a deployed value-division scheme. Moreover, we model the utility function by explicitly considering each peer's attributes as well as the cost for uploading content. To quantify the benefit that users derive from a coalition, we define the value of a coalition based on the total utility that all peers can achieve jointly in the coalition. Based on this definition of the coalition value, we use an axiomatic bargaining solution in order to fairly negotiate the value division of the upload bandwidth given each peer's attributes.

A peer-based study on adolescence nutritional health: a lesson learned from Iran.

Science.gov (United States)

Peykari, Niloofar; Tehrani, Fahimeh Ramezani; Eftekhari, Monir Baradaran; Malekafzali, Hossein; Dejman, Masoumeh; Neot, Rosemary; Djalalinia, Shirin

2011-06-01

To study the adolescence opinions' among nutritional habits and beliefs. To conduct a multi disciplinary approach through involving adolescence/youth for finding their mental needs and their suggestion for solving them, we designed a qualitative approach based on grounded theory. For data collection a semi-structured guide questioner designed and 16 focus group discussions were conducted by trained peers with youth aged 10-19 years. According to FGDs results, although majority of participants agreed on the important role of nutrition in health and the effect of nutritional habits on different aspect of health, they used modern and publicized fast foods. On the other hand, most of female and male participants said that different factors influenced the girls and boys diet selection i. e. girls' paid more attention to diet selection and taste and health of foods, whereas boys were careless and gluttony caused more food to be consumed. Adolescents' information (both genders) regarding nutritional problems resulting from improper food habits were not satisfactory. Peer-based health programmes through target groups for capacity building and participation of stakeholders will fulfill the objectives.

Peer-to-Peer Service Sharing Platforms

DEFF Research Database (Denmark)

Andersson, Magnus; Hjalmarsson, Anders; Avital, Michel

2013-01-01

The sharing economy has been growing continuously in the last decade thanks to the proliferation of internet-based platforms that allow people to disintermediate the traditional commercial channels and to share excess resources and trade with one another effectively at a reasonably low transaction...... cost. Whereas early peer-to-peer platforms were designed to enable file sharing and goods trading, we recently witness the emergence of a new breed of peer-to-peer platforms that are designed for ordinary service sharing. Ordinary services entail intangible provisions and are defined as an economic...... activity that generates immaterial benefits and does not result in ownership of material goods. Based on a structured analysis of 41 internet-based rideshare platforms, we explore and layout the unique characteristics of peer-to-peer service sharing platforms based on three distinct temporal patterns...

Rethinking HIV-prevention for school-going young people based on current behaviour patterns.

Science.gov (United States)

Visser, Maretha

2017-12-01

The aim of the research was to gain increased knowledge regarding the sexual risk behaviour of school-going young people in South Africa after two decades of HIV-education in schools, to contribute to the development of improved HIV prevention strategies. In collaboration with the Department of Education, a sample of 5305 learners (between 10 and 18 years in Grades 5-12) from high-risk communities were identified. They completed a survey that assessed self-reported sexual risk behaviour and variables that potentially underlie sexual risk, such as attitudes towards preventive behaviour, perceived social norms and self-efficacy (based on the theory of planned behaviour [TPB]) and social factors like caregiver relationships and gender norms (based on the social ecological theory). Lifetime sex was reported by 49.4% of boys and 30.5% of girls in Grades 8-12, while 56% of the sexually active young people reported consistent condom use. Accurate knowledge about HIV transmission was low (37.8%). Regression analysis showed that risk behaviour was more prominent among older male youths, who perceived social norms as encouraging sexual activity, who use alcohol excessively, and who have negative attitudes towards abstinence. Perceived traditional community gender norms and negative relationships with caregivers were also associated with sexual risk behaviour. This research showed that the TPB can be used in planning HIV prevention interventions for young people. It also revealed that HIV-prevention strategies should focus beyond educating the individual, to address community factors such as improving caregiver relationships, the culture of substance abuse, peer group norms and inequality in community gender norms. These community processes influence young people's behaviour and need to be addressed to allow the youth to make healthy behavioural choices.

Rethinking HIV-prevention for school-going young people based on current behaviour patterns

Science.gov (United States)

Visser, Maretha

2017-01-01

Abstract The aim of the research was to gain increased knowledge regarding the sexual risk behaviour of school-going young people in South Africa after two decades of HIV-education in schools, to contribute to the development of improved HIV prevention strategies. In collaboration with the Department of Education, a sample of 5305 learners (between 10 and 18 years in Grades 5–12) from high-risk communities were identified. They completed a survey that assessed self-reported sexual risk behaviour and variables that potentially underlie sexual risk, such as attitudes towards preventive behaviour, perceived social norms and self-efficacy (based on the theory of planned behaviour [TPB]) and social factors like caregiver relationships and gender norms (based on the social ecological theory). Lifetime sex was reported by 49.4% of boys and 30.5% of girls in Grades 8–12, while 56% of the sexually active young people reported consistent condom use. Accurate knowledge about HIV transmission was low (37.8%). Regression analysis showed that risk behaviour was more prominent among older male youths, who perceived social norms as encouraging sexual activity, who use alcohol excessively, and who have negative attitudes towards abstinence. Perceived traditional community gender norms and negative relationships with caregivers were also associated with sexual risk behaviour. This research showed that the TPB can be used in planning HIV prevention interventions for young people. It also revealed that HIV-prevention strategies should focus beyond educating the individual, to address community factors such as improving caregiver relationships, the culture of substance abuse, peer group norms and inequality in community gender norms. These community processes influence young people's behaviour and need to be addressed to allow the youth to make healthy behavioural choices. PMID:28934898

Adolescent HIV treatment issues in South Africa

African Journals Online (AJOL)

Following the discovery of the human immunodeficiency virus (HIV), our knowledge of HIV infection and management has increased ... This article highlights common treatment issues in HIV adolescent care and ... Oral sex is viewed as less risky and often this is not explored in the ... parents, peers and the community.

Network stigma towards people living with HIV/AIDS and their caregivers: An egocentric network study.

Science.gov (United States)

Wu, Fei; He, Xin; Guida, Jennifer; Xu, Yongfang; Liu, Hongjie

2015-10-01

HIV stigma occurs among peers in social networks. However, the features of social networks that drive HIV stigma are not well understood. The objective of this study is to investigate anticipated HIV stigma within the social networks of people living with HIV/AIDS (PLWHA) (N = 147) and the social networks of PLWHA's caregivers (N = 148). The egocentric social network data were collected in Guangxi, China. More than half of PLWHA (58%) and their caregivers (53%) anticipated HIV stigma from their network peers. Both PLWHA and their caregivers anticipated that spouses or other family members were less likely to stigmatise them, compared to friend peers or other relationships. Married network peers were believed to stigmatise caregivers more than unmarried peers. The association between frequent contacts and anticipated stigma was negative among caregivers. Being in a close relationship with PLWHA or caregivers (e.g., a spouse or other family member) was associated with less anticipated stigma. Lower network density was associated with higher anticipated stigma among PLWHA's alters, but not among caregivers' alters. Findings may shed light on innovative stigma reduction interventions at the social network level and therefore improve HIV/AIDS treatment utilisation.

The Use of Online Posts to Identify Barriers to and Facilitators of HIV Pre-exposure Prophylaxis (PrEP) Among Men Who Have Sex with Men: A Comparison to a Systematic Review of the Peer-Reviewed Literature.

Science.gov (United States)

Hannaford, Alisse; Lipshie-Williams, Madeleine; Starrels, Joanna L; Arnsten, Julia H; Rizzuto, Jessica; Cohen, Phillip; Jacobs, Damon; Patel, Viraj V

2018-04-01

Pre-exposure prophylaxis (PrEP) remains an under-utilized HIV prevention tool among men who have sex with men (MSM). To more comprehensively elucidate barriers and facilitators to PrEP use among US MSM, we conducted a systematic review of peer-reviewed published articles and content analysis of online posts about PrEP. We searched peer-reviewed databases (Medline, Web of Science, Google Scholar) using MESH headings and keywords about PrEP and/or HIV prevention from 2005 to 2015. We included original studies among MSM in the US that reported on barriers, facilitators, or other factors related to PrEP use. We also searched online posts and associated comments (news articles, opinion pieces, blogs and other social media posts) in diverse venues (Facebook, Slate Outward, Huffington Post Gay Voices, Queerty, and My PrEP Experience blog) to identify posts about PrEP. We used content analysis to identify themes and compare potential differences between the peer-reviewed literature and online posts. We identified 25 peer-reviewed articles and 28 online posts meeting inclusion criteria. We identified 48 unique barriers and 46 facilitators to using PrEP. These 94 themes fit into six overarching categories: (1) access (n = 14), (2) attitudes/beliefs (n = 24), (3) attributes of PrEP (n = 13), (4) behaviors (n = 11), (5) sociodemographic characteristics (n = 8), and (6) social network (n = 6). In all categories, analysis of online posts resulted in identification of a greater number of unique themes. Thirty-eight themes were identified in the online posts that were not identified in the peer-reviewed literature. We identified barriers and facilitators to PrEP in online posts that were not identified in a systematic review of the peer-reviewed literature. By incorporating data both from a systematic review of peer-reviewed articles and from online posts, we have identified salient and novel information about barriers to and facilitators of PrEP use. Traditional

Cognitive and psychosocial development of HIV pediatric patients receiving highly active anti-retroviral therapy: a case-control study

Directory of Open Access Journals (Sweden)

Theodoridou Maria

2010-12-01

Full Text Available Abstract Background The psychosocial development of pediatric HIV patients has not been extensively evaluated. The study objectives were to evaluate whether emotional and social functions are differentially associated with HIV-related complications. Methods A matched case-control study design was conducted. The case group (n = 20 consisted of vertically infected children with HIV (aged 3-18 years receiving HAART in Greece. Each case was matched with two randomly selected healthy controls from a school-based population. CNS imaging and clinical findings were used to identify patients with HIV-related neuroimaging abnormalities. The Wechsler Intelligence Scale III and Griffiths Mental Abilities Scales were applied to assess cognitive abilities. The age specific Strengths and Difficulties Questionnaire was used to evaluate emotional adjustment and social skills. The Fisher's exact test, student's t-test, and Wilcoxon rank sum test were used to compare categorical, continuous, and ordinal scores, respectively, of the above scales between groups. Results HIV patients without neuroimaging abnormalities did not differ from patients with neuroimaging abnormalities with respect to either age at HAART initiation (p = 0.306 or months of HAART treatment (p = 0.964. While HIV patients without neuroimaging abnormalities had similar cognitive development with their healthy peers, patients with neuroimaging abnormalities had lower mean General (p = 0.027 and Practical (p = 0.042 Intelligence Quotient scores. HIV patients without neuroimaging abnormalities had an increased likelihood of both Abnormal Emotional Symptoms (p = 0.047 and Hyperactivity scores (p = 0.0009. In contrast, HIV patients with neuroimaging abnormalities had an increased likelihood of presenting with Abnormal Peer Problems (p = 0.033. Conclusions HIV patients without neuroimaging abnormalities are more likely to experience maladjustment with respect to their emotional and activity spheres

Adolescent girls and young women: key populations for HIV epidemic control.

Science.gov (United States)

Dellar, Rachael C; Dlamini, Sarah; Karim, Quarraisha Abdool

2015-01-01

At the epicentre of the HIV epidemic in southern Africa, adolescent girls and young women aged 15-24 contribute a disproportionate ~30% of all new infections and seroconvert 5-7 years earlier than their male peers. This age-sex disparity in HIV acquisition continues to sustain unprecedentedly high incidence rates, and preventing HIV infection in this age group is a pre-requisite for achieving an AIDS-free generation and attaining epidemic control. Adolescent girls and young women in southern Africa are uniquely vulnerable to HIV and have up to eight times more infection than their male peers. While the cause of this vulnerability has not been fully elucidated, it is compounded by structural, social and biological factors. These factors include but are not limited to: engagement in age-disparate and/or transactional relationships, few years of schooling, experience of food insecurity, experience of gender-based violence, increased genital inflammation, and amplification of effects of transmission co-factors. Despite the large and immediate HIV prevention need of adolescent girls and young women, there is a dearth of evidence-based interventions to reduce their risk. The exclusion of adolescents in biomedical research is a huge barrier. School and community-based education programmes are commonplace in many settings, yet few have been evaluated and none have demonstrated efficacy in preventing HIV infection. Promising data are emerging on prophylactic use of anti-retrovirals and conditional cash transfers for HIV prevention in these populations. There is an urgent need to meet the HIV prevention needs of adolescent girls and young women, particularly those who are unable to negotiate monogamy, condom use and/or male circumcision. Concerted efforts to expand the prevention options available to these young women in terms of the development of novel HIV-specific biomedical, structural and behavioural interventions are urgently needed for epidemic control. In the interim

A taxonomy for community-based care programs focused on HIV/AIDS prevention, treatment, and care in resource-poor settings.

Science.gov (United States)

Rachlis, Beth; Sodhi, Sumeet; Burciul, Barry; Orbinski, James; Cheng, Amy H Y; Cole, Donald

2013-04-16

Community-based care (CBC) can increase access to key services for people affected by HIV/AIDS through the mobilization of community interests and resources and their integration with formal health structures. Yet, the lack of a systematic framework for analysis of CBC focused on HIV/AIDS impedes our ability to understand and study CBC programs. We sought to develop taxonomy of CBC programs focused on HIV/AIDS in resource-limited settings in an effort to understand their key characteristics, uncover any gaps in programming, and highlight the potential roles they play. Our review aimed to systematically identify key CBC programs focused on HIV/AIDS in resource-limited settings. We used both bibliographic database searches (Medline, CINAHL, and EMBASE) for peer-reviewed literature and internet-based searches for gray literature. Our search terms were 'HIV' or 'AIDS' and 'community-based care' or 'CBC'. Two co-authors developed a descriptive taxonomy through an iterative, inductive process using the retrieved program information. We identified 21 CBC programs useful for developing taxonomy. Extensive variation was observed within each of the nine categories identified: region, vision, characteristics of target populations, program scope, program operations, funding models, human resources, sustainability, and monitoring and evaluation strategies. While additional research may still be needed to identify the conditions that lead to overall program success, our findings can help to inform our understanding of the various aspects of CBC programs and inform potential logic models for CBC programming in the context of HIV/AIDS in resource-limited settings. Importantly, the findings of the present study can be used to develop sustainable HIV/AIDS-service delivery programs in regions with health resource shortages.

Myths, science and stories: working with peer educators to counter ...

African Journals Online (AJOL)

The failure to bring about widespread or effective behavioural change in response to South Africa's HIV epidemic requires that new forms of health communication be explored. This article reports on an action research project in which a group of workplace HIV/AIDS peer educators at a South African mining company ...

Measuring the impact of HIV and STIs in a community in a coal mining town, Mpumalanga, South Africa

Energy Technology Data Exchange (ETDEWEB)

Hurkchand, H.; Makuluma, H.; Molefe, N.; Molapo, M.

2005-07-01

A cross-sectional study was conducted in November 2001 to establish the prevalence rates of Human Immunodeficiency Virus (HIV) and sexually transmitted infections (STIs) (Chlamydia trachomatis and Neisseria gonorrhoea) in a coalmining town in Mpumalanga. HIV prevalence in this community is high, and corresponds to national figures. However, the prevalence of STIs is surprisingly low as it would be expected to be high in a migrant population. Although communities are exposed to expanding peer-education activities that encourage behaviour change, the prevalence of HIV in this group. There is an urgent need for interventions designed to treat or prevent HIV infection in women generally and in women at high risk.

The impact of criminalization of HIV non-disclosure on the healthcare engagement of women living with HIV in Canada: a comprehensive review of the evidence.

Science.gov (United States)

Patterson, Sophie E; Milloy, M-J; Ogilvie, Gina; Greene, Saara; Nicholson, Valerie; Vonn, Micheal; Hogg, Robert; Kaida, Angela

2015-01-01

In 2012, the Supreme Court of Canada ruled that people living with HIV (PLWH) must disclose their HIV status to sexual partners prior to sexual activity that poses a "realistic possibility" of HIV transmission for consent to sex to be valid. The Supreme Court deemed that the duty to disclose could be averted if a person living with HIV both uses a condom and has a low plasma HIV-1 RNA viral load during vaginal sex. This is one of the strictest legal standards criminalizing HIV non-disclosure worldwide and has resulted in a high rate of prosecutions of PLWH in Canada. Public health advocates argue that the overly broad use of the criminal law against PLWH undermines efforts to engage individuals in healthcare and complicates gendered barriers to linkage and retention in care experienced by women living with HIV (WLWH). We conducted a comprehensive review of peer-reviewed and non-peer-reviewed evidence published between 1998 and 2015 evaluating the impact of the criminalization of HIV non-disclosure on healthcare engagement of WLWH in Canada across key stages of the cascade of HIV care, specifically: HIV testing and diagnosis, linkage and retention in care, and adherence to antiretroviral therapy. Where available, evidence pertaining specifically to women was examined. Where these data were lacking, evidence relating to all PLWH in Canada or other international jurisdictions were included. Evidence suggests that criminalization of HIV non-disclosure may create barriers to engagement and retention within the cascade of HIV care for PLWH in Canada, discouraging access to HIV testing for some people due to fears of legal implications following a positive diagnosis, and compromising linkage and retention in healthcare through concerns of exposure of confidential medical information. There is a lack of published empirical evidence focused specifically on women, which is a concern given the growing population of WLWH in Canada, among whom marginalized and vulnerable women

Impact of five years of peer-mediated interventions on sexual behavior and sexually transmitted infections among female sex workers in Mombasa, Kenya

Directory of Open Access Journals (Sweden)

King'ola Nzioki

2008-04-01

Full Text Available Abstract Background Since 2000, peer-mediated interventions among female sex workers (FSW in Mombasa Kenya have promoted behavioural change through improving knowledge, attitudes and awareness of HIV serostatus, and aimed to prevent HIV and other sexually transmitted infection (STI by facilitating early STI treatment. Impact of these interventions was evaluated among those who attended peer education and at the FSW population level. Methods A pre-intervention survey in 2000, recruited 503 FSW using snowball sampling. Thereafter, peer educators provided STI/HIV education, condoms, and facilitated HIV testing, treatment and care services. In 2005, data were collected using identical survey methods, allowing comparison with historical controls, and between FSW who had or had not received peer interventions. Results Over five years, sex work became predominately a full-time activity, with increased mean sexual partners (2.8 versus 4.9/week; P P P = 0.36. Conclusion Peer-mediated interventions were associated with an increase in protected sex. Though peer-mediated interventions remain important, higher coverage is needed and more efficacious interventions to reduce overall vulnerability and risk.

DRD4 Genotype and the Developmental Link of Peer Social Preference with Conduct Problems and Prosocial Behavior Across Ages 9-12 Years.

Science.gov (United States)

Buil, J Marieke; Koot, Hans M; Olthof, Tjeert; Nelson, Kelly A; van Lier, Pol A C

2015-07-01

The peer environment is among the most important factors for children's behavioral development. However, not all children are equally influenced by their peers, which is potentially due to their genetic make-up. The dopamine receptor D4 gene (DRD4) is a potential candidate gene that may influence children's susceptibility to the peer environment. In the present study, we explored whether variations in the DRD4 gene moderated the association between children's social standing in the peer group (i.e., social preference among classmates) with subsequent conduct problems and prosocial behavior among 405 (51% females) elementary school children followed annually throughout early adolescence (ages 9-12 years). The behavioral development of children with and without the DRD4 7-repeat allele was compared. The results indicated that children who had higher positive social preference scores (i.e., who were more liked relative to disliked by their peers) showed less conduct problem development in subsequent years relative to children who had lower positive social preference scores. In contrast, children who had more negative preference scores (i.e., who were more disliked relative to liked among peers) showed more conduct problem development in subsequent years, relative to children who had less negative preference scores. However, these effects only occurred when children had a 7-repeat allele. For children who did not have a 7-repeat allele, the level of social preference was not associated with subsequent conduct problems. No evidence for gene-environment interaction effects for prosocial behavior was found. The implications for our understanding of conduct problem development and its prevention are discussed.

Evidence-based practice: a quality indicator analysis of peer-tutoring in adapted physical education.

Science.gov (United States)

Kalef, Laura; Reid, Greg; Macdonald, Cathy

2013-09-01

The purpose of the research was to conduct a quality indicator analysis of studies investigating peer-tutoring for students with a disability in adapted physical education. An electronic search was conducted among English journals published from 1960 to November 2012. Databases included ERIC, PsycINFO, and SPORTDiscus. Fifteen research studies employing group-experimental (Gersten et al., 2005) or single-subject designs (Horner et al., 2005) met inclusion criteria. Each study was assessed for the presence and clarity of quality indicators. Group designs met an average of 62.5% essential and 69% desirable indicators. An average of 80% of indicators was present for single-subject designs. Results suggest claims of peer-tutoring being an evidence-based practice are premature. Recommendations for clarifying and applying the quality indicators are offered. Copyright © 2013 Elsevier Ltd. All rights reserved.

HIV incidence in Asia: a review of available data and assessment of the epidemic.

Science.gov (United States)

Dokubo, E Kainne; Kim, Andrea A; Le, Linh-Vi; Nadol, Patrick J; Prybylski, Dimitri; Wolfe, Mitchell I

2013-01-01

Rates of new HIV infections in Asia are poorly characterized, likely resulting in knowledge gaps about infection trends and the most important areas to target for interventions. We conducted a systematic review of peer-reviewed English language publications and conference abstracts on HIV incidence in thirteen countries - Bangladesh, Cambodia, China, India, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Taiwan, Thailand, and Vietnam. We obtained data on HIV incidence rate, incidence estimation method, population, and risk factors for incident infection. Our search yielded 338 unique incidence estimates from 70 published articles and 41 conference abstracts for eight countries. A total of 138 (41%) were obtained from prospective cohort studies and 106 (31%) were from antibody-based tests for recent infection. High HIV incidence rates were observed among commercial sex workers (0.4-27.8 per 100 person-years), people who inject drugs (0.0-43.6 per 100 person-years) and men who have sex with men (0.7-15.0 per 100 person-years). Risk factors for incident HIV infection include brothel-based sex work and cervicitis among commercial sex workers; young age, frequent injection use and sharing needles or syringes among people who inject drugs; multiple male sexual partners, receptive anal intercourse and syphilis infection among men who have sex with men. In the countries with available data, incidence rates were highest in key populations and varied widely by incidence estimation method. Established surveillance systems that routinely monitor trends in HIV incidence are needed to inform prevention planning, prioritize resources, measure impact, and improve the HIV response in Asia.

The Effects of Autonomy Support on Student Engagement in Peer Assessment

Science.gov (United States)

Yuan, Jiangmei; Kim, ChanMin

2018-01-01

Although peer assessment is widely implemented in higher education, not all students are highly engaged in it. To enhance student engagement in peer assessment, we designed and developed a web-based tool, autonomy-supportive peer assessment (ASPA), to support students' need for autonomy when they conducted peer assessment. Students' sense of…

Perceptions of Peer Review Using Cloud-Based Software

Science.gov (United States)

Andrichuk, Gjoa

2016-01-01

This study looks at the change in perception regarding the effect of peer feedback on writing skills using cloud-based software. Pre- and post-surveys were given. The students peer reviewed drafts of five sections of scientific reports using Google Docs. While students reported that they did not perceive their writing ability improved by being…

What women want: social characteristics, gender-based violence and social support preferences in a cohort of women living with HIV.

Science.gov (United States)

Wielding, Sally; Scott, Alison

2017-04-01

A total of 229 women attend Chalmers Centre (a city-centre integrated sexual health centre in Edinburgh, Scotland) for their HIV care and treatment. Local third-sector agencies provide peer support, but anecdotally, it is not well utilised and some demographic groups are under-represented. The aim of this study was to gain better understanding of the background social characteristics of these women, to ascertain what issues they are affected by, and to better identify what support is required and how it should be provided/facilitated. An anonymous self-completion questionnaire was developed, and all women attending HIV clinics between July and November 2015 were given the opportunity to participate. Additional data were accessed from the National Sexual Health database on cohort size and gender-based violence enquiries. Forty-four women living with HIV completed the questionnaire. 25% are unemployed. 84.6% had a combined household income of less than £30,000 per annum. 16.7% do not know anyone else, and 59.5% know only one other person, who is living with HIV. 32.6% would like to meet other/more women living with HIV, and 25.5% were unsure if they did or not. Of those who would, 42.9% would prefer a one-to-one setting, 42.9% would prefer a group setting, and 14.3% did not mind. 64.3% would prefer to meet off NHS premises. 26.8% were interested in discussion groups on women's issues, and 31.7% were unsure. The most popular suggestions for discussion group topics were stress/anxiety (nine women), HIV disclosure (eight women), diet and nutrition (seven women), and pregnancy and childbirth (six women). 26.8% were interested in attending a "women clinic" staffed by female staff, the same number were unsure if they would utilise this service or not. 50% of women had, at some point, experienced gender-based violence, 13.5% were currently experiencing gender-based violence, and four of these women have children living with them. From National Sexual Health records, only

Student Voices: Perspectives on Peer-to-Peer Sexual Health Education.

Science.gov (United States)

Layzer, Carolyn; Rosapep, Lauren; Barr, Sherry

2017-07-01

This process study is a companion to a randomized evaluation of a school-based, peer-led comprehensive sexual health education program, Teen Prevention Education Program (Teen PEP), in which 11th- and 12th-grade students are trained by school health educators to conduct informative workshops with ninth-grade peers in schools in North Carolina. The process study was designed to understand youth participants' perspectives on the program in order to gain insight into program effectiveness. This is a mixed-methods study in 7 schools, with online surveys (N = 88) and 8 focus groups with peer educators (N = 116), end-of-program surveys (N = 1122), 8 focus groups with ninth-grade workshop participants (N = 89), and observations of the Teen PEP class and workshops during the semester of implementation in each school, 2012-2014. Both peer educators and ninth graders perceived benefits of participating in Teen PEP across a range of domains, including intentions, skills, and knowledge and that the peer education modality was important in their valuation of the experience. Our findings suggest that the peer-led comprehensive sexual health education approach embodied in Teen PEP can be an important educational mechanism for teaching students information and skills to promote sexual health. © 2017, American School Health Association.

Planning peer education programmes in the workplace.

Science.gov (United States)

Hirschmann De Salazar, A

1998-01-01

In Guatemala, the HIV/AIDS epidemic is expected to have a vast negative impact on private enterprises as employees battle the disease in themselves and in family members. In response, the Guatemalan Association for the Prevention and Control of AIDS (AGPCS) developed a program to train private sector employees in peer health education. The program began by informing employers about the potential impact of HIV/AIDS on the private sector. Then AGPCS designed a workshop consisting of 11 two-hour weekly modules to provide up to 30 participants with information on sexually transmitted diseases, AIDS, and related issues. The first business to take advantage of the program was a 7000-employee clothing factory that continues to implement HIV prevention strategies. However, concern about the loss of employee time impeded other companies from participating. AGPCS, therefore, increased its flexibility and gave employers the option of sending employees to fewer seminars on topics the employers choose. This new approach led to 31 workshops in 1997 and 28 by August 1998. Also, in 1998, one company hired AGPCS to present 20 workshops to all of their employees. Efforts are made to evaluate workshop effectiveness and to facilitate follow-up activities. Peer education is an important part of the program, and potential peer educators are provided with a manual, extra training, and follow-up help. The training has helped companies develop work-place AIDS policies, and the AGPCS project has become sustainable.

Advancing Behavioral HIV Prevention: Adapting an Evidence-Based Intervention for People Living with HIV and Alcohol Use Disorders

Directory of Open Access Journals (Sweden)

M. L. Armstrong

2015-01-01

Full Text Available Alcohol use disorders (AUDs are highly prevalent among people living with HIV/AIDS (PLWHA and are associated with increased HIV risk behaviors, suboptimal treatment adherence, and greater risk for disease progression. We used the ADAPT-ITT strategy to adapt an evidence-based intervention (EBI, the Holistic Health Recovery Program (HHRP+, that focuses on secondary HIV prevention and antiretroviral therapy (ART adherence and apply it to PLWHA with problematic drinking. Focus groups (FGs were conducted with PLWHA who consume alcohol and with treatment providers at the largest HIV primary care clinic in New Orleans, LA. Overall themes that emerged from the FGs included the following: (1 negative mood states contribute to heavy alcohol consumption in PLWHA; (2 high levels of psychosocial stress, paired with few adaptive coping strategies, perpetuate the use of harmful alcohol consumption in PLWHA; (3 local cultural norms are related to the permissiveness and pervasiveness of drinking and contribute to heavy alcohol use; (4 healthcare providers unanimously stated that outpatient options for AUD intervention are scarce, (5 misperceptions about the relationships between alcohol and HIV are common; (6 PLWHA are interested in learning about alcohol’s impact on ART and HIV disease progression. These data were used to design the adapted EBI.

An agent-based peer-to-peer architecture for semantic discovery of manufacturing services across virtual enterprises

Science.gov (United States)

Zhang, Wenyu; Zhang, Shuai; Cai, Ming; Jian, Wu

2015-04-01

With the development of virtual enterprise (VE) paradigm, the usage of serviceoriented architecture (SOA) is increasingly being considered for facilitating the integration and utilisation of distributed manufacturing resources. However, due to the heterogeneous nature among VEs, the dynamic nature of a VE and the autonomous nature of each VE member, the lack of both sophisticated coordination mechanism in the popular centralised infrastructure and semantic expressivity in the existing SOA standards make the current centralised, syntactic service discovery method undesirable. This motivates the proposed agent-based peer-to-peer (P2P) architecture for semantic discovery of manufacturing services across VEs. Multi-agent technology provides autonomous and flexible problemsolving capabilities in dynamic and adaptive VE environments. Peer-to-peer overlay provides highly scalable coupling across decentralised VEs, each of which exhibiting as a peer composed of multiple agents dealing with manufacturing services. The proposed architecture utilises a novel, efficient, two-stage search strategy - semantic peer discovery and semantic service discovery - to handle the complex searches of manufacturing services across VEs through fast peer filtering. The operation and experimental evaluation of the prototype system are presented to validate the implementation of the proposed approach.

Use of peers to improve adherence to antiretroviral therapy: a global network meta-analysis.

Science.gov (United States)

Kanters, Steve; Park, Jay Jh; Chan, Keith; Ford, Nathan; Forrest, Jamie; Thorlund, Kristian; Nachega, Jean B; Mills, Edward J

2016-01-01

It is unclear whether using peers can improve adherence to antiretroviral therapy (ART). To construct the World Health Organization's global guidance on adherence interventions, we conducted a systematic review and network meta-analysis to determine the effectiveness of using peers for achieving adequate adherence and viral suppression. We searched for randomized clinical trials of peer-based interventions to promote adherence to ART in HIV populations. We searched six electronic databases from inception to July 2015 and major conference abstracts within the last three years. We examined the outcomes of adherence and viral suppression among trials done worldwide and those specific to low- and middle-income countries (LMIC) using pairwise and network meta-analyses. Twenty-two trials met the inclusion criteria. We found similar results between pairwise and network meta-analyses, and between the global and LMIC settings. Peer supporter+Telephone was superior in improving adherence than standard-of-care in both the global network (odds-ratio [OR]=4.79, 95% credible intervals [CrI]: 1.02, 23.57) and the LMIC settings (OR=4.83, 95% CrI: 1.88, 13.55). Peer support alone, however, did not lead to improvement in ART adherence in both settings. For viral suppression, we found no difference of effects among interventions due to limited trials. Our analysis showed that peer support leads to modest improvement in adherence. These modest effects may be due to the fact that in many settings, particularly in LMICs, programmes already include peer supporters, adherence clubs and family disclosures for treatment support. Rather than introducing new interventions, a focus on improving the quality in the delivery of existing services may be a more practical and effective way to improve adherence to ART.

Families as catalysts for peer adherence support in enhancing hope for people living with HIV/AIDS in South Africa.

Science.gov (United States)

Masquillier, Caroline; Wouters, Edwin; Mortelmans, Dimitri; Booysen, Frederik le Roux

2014-01-01

Hope is an essential dimension of successful coping in the context of illnesses such as HIV/AIDS, because positive expectations for the future alleviate emotional distress, enhance quality of life and have been linked to the capacity for behavioural change. The social environment (e.g. family, peers) is a regulator of hope for people living with HIV/AIDS (PLWHA). In this regard, the dual aim of this article is (1) to analyze the influence of a peer adherence support (PAS) intervention and the family environment on the state of hope in PLWHA and (2) to investigate the interrelationship between the two determinants. The Effective AIDS Treatment and Support in the Free State study is a prospective randomized controlled trial. Participants were recruited from 12 public antiretroviral treatment (ART) clinics across five districts in the Free State Province of South Africa. Each of these patients was assigned to one of the following groups: a control group receiving standard care, a group receiving additional biweekly PAS or a group receiving PAS and nutritional support. Latent cross-lagged modelling (Mplus) was used to analyse the impact of PAS and the family environment on the level of hope in PLWHA. The results of the study indicate that neither PAS nor the family environment has a direct effect on the level of hope in PLWHA. Subsequent analysis reveals a positive significant interaction between family functioning and PAS at the second follow-up, indicating that better family functioning increases the positive effect of PAS on the state of hope in PLWHA. The interplay between well-functioning families and external PAS generates higher levels of hope, which is an essential dimension in the success of lifelong treatment. This study provides additional insight into the important role played by family dynamics in HIV/AIDS care, and it underscores the need for PAS interventions that are sensitive to the contexts in which they are implemented.

Getting PrEPared for HIV Prevention Navigation: Young Black Gay Men Talk About HIV Prevention in the Biomedical Era.

Science.gov (United States)

Mutchler, Matt G; McDavitt, Bryce; Ghani, Mansur A; Nogg, Kelsey; Winder, Terrell J A; Soto, Juliana K

2015-09-01

Biomedical HIV prevention strategies, such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), represent new opportunities to reduce critically high HIV infection rates among young black men who have sex with men (YBMSM). We report results of 24 dyadic qualitative interviews (N=48), conducted in Los Angeles, CA, exploring how YBMSM and their friends view PrEP and PEP. Interviews were analyzed using a grounded theory approach. Participants had widely divergent levels of knowledge about these prevention methods. Misconceptions and mistrust regarding PrEP were common, and concerns were expressed about PrEP-related stigma and the potential for gossip among peers who might assume a person on PrEP was HIV-positive. Yet participants also framed PrEP and PEP as valuable new options within an expanded "tool kit" of HIV prevention strategies that created possibilities for preventing new HIV infections, dating men with a different HIV status, and decreased anxiety about exposure to HIV. We organized themes around four main areas: (1) information and misinformation about biomedical HIV prevention; (2) expectations about PrEP, sexual behavior, and stigma; (3) gossip, disclosure, and "spreading the word" about PrEP and PEP; and (4) the roles of PrEP and PEP in an expanded HIV prevention tool kit. The findings suggest a need for guidance in navigating the increasingly complex array of HIV-prevention options available to YBMSM. Such "prevention navigation" could counter misconceptions and address barriers, such as stigma and mistrust, while helping YBMSM make informed selections from among expanded HIV prevention options.

Caregiver perceptions and motivation for disclosing or concealing the diagnosis of HIV infection to children receiving HIV care in Mbarara, Uganda: a qualitative study.

Directory of Open Access Journals (Sweden)

Julius Kiwanuka

Full Text Available Disclosure of the diagnosis of HIV to HIV-infected children is challenging for caregivers. Despite current recommendations, data suggest that levels of disclosure of HIV status to HIV-infected children receiving care in resource-limited settings are very low. Few studies describe the disclosure process for children in these settings, particularly the motivators, antecedent goals, and immediate outcomes of disclosure to HIV-infected children. This study examined caregivers' perception of the disclosure concept prior to disclosure, their motivation towards or away from disclosure, and their short- and long-term intentions for disclosure to their HIV-infected children.In-depth interviews were conducted with primary caregivers of 40 HIV-infected children (ages 5-15 years who were receiving HIV care but did not know their HIV status.Caregivers of HIV-infected children mainly perceived disclosure as a single event rather than a process of gradual delivery of information about the child's illness. They viewed disclosure as potentially beneficial both to children and themselves, as well as an opportunity to explain the parents' role in the transmission of HIV to the children. Caregivers desired to personally conduct the disclosure; however, most reported being over-whelmed with fear of negative outcomes and revealed a lack of self-efficacy towards managing the disclosure process. Consequently, most cope by deception to avoid or delay disclosure until they perceive their own readiness to disclose.Interventions for HIV disclosure should consider that caregivers may desire to be directly responsible for disclosure to children under their care. They, however, need to be empowered with practical skills to recognize opportunities to initiate the disclosure process early, as well as supported to manage it in a phased, developmentally appropriate manner. The potential role for peer counselors in the disclosure process deserves further study.

A peer-based study on adolescence nutritional health: a lesson learned from Iran

International Nuclear Information System (INIS)

Peykari, N.; Eftekhari, M.B.; Neot, R.; Djalalinia, S.

2011-01-01

To study the adolescence opinions among nutritional habits and beliefs. Methods: To conduct a multi disciplinary approach through involving adolescence /youth for finding their mental needs and their suggestion for solving them, we designed a qualitative approach based on grounded theory. For data collection a semi-structured guide questioner designed and 16 focus group discussions were conducted by trained peers with youth aged 10-19 years. Results: According to FGDs results, although majority of participants agreed on the important role of nutrition in health and the effect of nutritional habits on different aspect of health, they used modern and publicized fast foods. On the other hand, most of female and male participants said that different factors influenced the girls and boys diet selection i. e. girls's paid more attention to diet selection and taste and health of foods, whereas boys were careless and gluttony caused more food to be consumed. Conclusion: Adolescents' information (both genders) regarding nutritional problems resulting from improper food habits were not satisfactory. Peer-based health programmes through target groups for capacity building and participation of stake holders will fulfill the objectives. (author)

Sex workers perspectives on strategies to reduce sexual exploitation and HIV risk: a qualitative study in Tijuana, Mexico.

Directory of Open Access Journals (Sweden)

Shira M Goldenberg

Full Text Available Globally, female sex workers are a population at greatly elevated risk of HIV infection, and the reasons for and context of sex industry involvement have key implications for HIV risk and prevention. Evidence suggests that experiences of sexual exploitation (i.e., forced/coerced sex exchange contribute to health-related harms. However, public health interventions that address HIV vulnerability and sexual exploitation are lacking. Therefore, the objective of this study was to elicit recommendations for interventions to prevent sexual exploitation and reduce HIV risk from current female sex workers with a history of sexual exploitation or youth sex work. From 2010-2011, we conducted in-depth interviews with sex workers (n = 31 in Tijuana, Mexico who reported having previously experienced sexual exploitation or youth sex work. Participants recommended that interventions aim to (1 reduce susceptibility to sexual exploitation by providing social support and peer-based education; (2 mitigate harms by improving access to HIV prevention resources and psychological support, and reducing gender-based violence; and (3 provide opportunities to exit the sex industry via vocational supports and improved access to effective drug treatment. Structural interventions incorporating these strategies are recommended to reduce susceptibility to sexual exploitation and enhance capacities to prevent HIV infection among marginalized women and girls in Mexico and across international settings.

Pilot Testing an Internet-Based STI and HIV Prevention Intervention With Chilean Women

Science.gov (United States)

Villegas, Natalia; Santisteban, Daniel; Cianelli, Rosina; Ferrer, Lilian; Ambrosia, Todd; Peragallo, Nilda; Lara, Loreto

2015-01-01

Purpose The incidence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is high among young Chilean women, and there are no STI or HIV prevention interventions available to them that incorporate technology. The purpose of this study was to investigate the preliminary efficacy of an Internet-based STI and HIV prevention intervention (I-STIPI) for Chilean young women on measures of STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors. Design This is a pretest-posttest study. Forty young Chilean women between 18 and 24 years of age participated in an investigation of the I-STIPI’s preliminary efficacy on STI and HIV prevention-related outcomes between baseline and a postintervention assessment. The intervention consisted of four online modules. Data collection was conducted in Santiago, Chile. Paired-samples t test analysis was used to determine whether there were significant differences in each of the outcome variables. Findings After receiving I-STIPI, women reported a significant increase in levels of STI- and HIV-related knowledge, attitudes toward the use of condoms and perceived self-efficacy, and a reduction of risky sexual behaviors with uncommitted partners. Conclusions The I-STIPI showed promise as an Internet-based intervention that can reduce barriers to accessing preventive interventions and increase STI and HIV preventive behaviors in young Chilean women. Clinical Relevance The study provided important information about the ability of an Internet-based intervention to reduce young women’s risk factors and to provide positive preliminary efficacy on STI- and HIV-related outcomes. Internet-based interventions can eliminate many barriers to receiving prevention interventions and may prove to be cost effective. PMID:25410132

Identifying medication-related needs of HIV patients: foundation for community pharmacist-based services

Directory of Open Access Journals (Sweden)

Yardlee Kauffman

2014-01-01

Full Text Available Background: Patients living with HIV/AIDS have complex medication regimens. Pharmacists within community pharmacy settings can have a role managing patients living with HIV/AIDS. Patients' perspectives surrounding implementation about community pharmacist-based services is needed as limited information is available. Objective: To identify medication-related needs of HIV-infected patients who receive prescriptions from a community pharmacy. To determine patient perspectives and knowledge of community pharmacist-based services. Methods: A qualitative research study involving in-depth, semi-structured interviews with patients was conducted. Inclusion criteria included: HIV positive men and women at least 18 years of age who receive care at a HIV clinic, currently take medication(s and use a community pharmacy for all prescription fills. Patients were recruited from one urban and one rural health center. Patients answered questions about their perceptions and knowledge about the role and value of pharmacy services and completed a demographic survey. The recordings of the interviews were transcribed verbatim and were analyzed using principles of Grounded Theory. Results: Twenty-nine interviews were conducted: 15 participants from the urban site and 14 from the rural site. Five main themes emerged including: patients experience ongoing and varying medication-related needs; patients desire a pharmacist who is caring, knowledgeable and integrated with health care providers; patients expect ready access to drug therapy; patients value an individualized patient encounter, and patients need to be informed that a pharmacist-service exists. Conclusion: Patients with HIV value individualized and personal encounters with pharmacists at time intervals that are convenient for the patient. Patients felt that a one-on-one encounter with a pharmacist would be most valuable when initiating or modifying medication therapy. These patient perspectives can be useful for

Effects of Peer-Facilitated, Video-Based and Combined Peer-and-Video Education on Anxiety Among Patients Undergoing Coronary Angiography: Randomised controlled trial.

Science.gov (United States)

Habibzadeh, Hosein; Milan, Zahra D; Radfar, Moloud; Alilu, Leyla; Cund, Audrey

2018-02-01

Coronary angiography can be stressful for patients and anxiety-caused physiological responses during the procedure increase the risk of dysrhythmia, coronary artery spasms and rupture. This study therefore aimed to investigate the effects of peer, video and combined peer-and-video training on anxiety among patients undergoing coronary angiography. This single-blinded randomised controlled clinical trial was conducted at two large educational hospitals in Iran between April and July 2016. A total of 120 adult patients undergoing coronary angiography were recruited. Using a block randomisation method, participants were assigned to one of four groups, with those in the control group receiving no training and those in the three intervention groups receiving either peer-facilitated training, video-based training or a combination of both. A Persian-language validated version of the State-Trait Anxiety Inventory was used to measure pre- and post-intervention anxiety. There were no statistically significant differences in mean pre-intervention anxiety scores between the four groups (F = 0.31; P = 0.81). In contrast, there was a significant reduction in post-intervention anxiety among all three intervention groups compared to the control group (F = 27.71; P <0.01); however, there was no significant difference in anxiety level in terms of the type of intervention used. Peer, video and combined peer-and-video education were equally effective in reducing angiography-related patient anxiety. Such techniques are recommended to reduce anxiety amongst patients undergoing coronary angiography in hospitals in Iran.

Are Cultural Values and Beliefs Included in U.S. Based HIV Interventions?

Science.gov (United States)

Wyatt, Gail E.; Williams, John K.; Gupta, Arpana; Malebranche, Dominique

2013-01-01

Objective To determine the extent to which current U.S. based HIV/AIDS prevention and risk reduction interventions address and include aspects of cultural beliefs in definitions, curricula, measures and related theories that may contradict current safer sex messages. Method A comprehensive literature review was conducted to determine which published HIV/AIDS prevention and risk reduction interventions incorporated aspects of cultural beliefs. Results This review of 166 HIV prevention and risk reduction interventions, published between 1988 and 2010, identified 34 interventions that varied in cultural definitions and the integration of cultural concepts. Conclusion HIV interventions need to move beyond targeting specific populations based upon race/ethnicity, gender, sexual, drug and/or risk behaviors and incorporate cultural beliefs and experiences pertinent to an individual’s risk. Theory based interventions that incorporate cultural beliefs within a contextual framework are needed if prevention and risk reduction messages are to reach targeted at risk populations. Implications for the lack of uniformity of cultural definitions, measures and related theories are discussed and recommendations are made to ensure that cultural beliefs are acknowledged for their potential conflict with safer sex skills and practices. PMID:21884721

The relationships between HIV stigma, emotional status, and emotional regulation among HIV-affected children in rural China.

Science.gov (United States)

Wei, Wei; Li, Xiaoming; Harrison, Sayward; Zhao, Junfeng; Zhao, Guoxiang

2016-03-01

Children affected by HIV/AIDS have unique psychosocial needs that often go unaddressed in traditional treatment approaches. They are more likely than unaffected peers to encounter stigma, including overt discriminatory behaviors, as well as stereotyped attitudes. In addition, HIV-affected children are at risk for experiencing negative affect, including sadness and depression. Previous studies have identified a link between HIV stigma and the subsequent emotional status of children affected by HIV/AIDS. However, limited data are available regarding protective psychological factors that can mitigate the effects of HIV stigma and thus promote resiliency for this vulnerable population. Utilizing data from 790 children aged 6-17 years affected by parental HIV in rural central China this study aims to examine the association between HIV stigma, including both enacted and perceived stigma, and emotional status among HIV-affected children, as well as to evaluate the mediating effects of emotional regulation on the relationship between HIV stigma and emotional status. In addition, the moderating role of age is tested. Multiple regression was conducted to test the mediation model. We found that the experience of HIV stigma had a direct positive effect on negative emotions among children affected by HIV. Emotional regulation offers a level of protection, as it mediated the impact of HIV stigma on negative emotions. Moreover, age was found to moderate the relationship between perceived stigma and negative emotions. A significant interaction between perceived stigma and age suggested that negative emotions increase with age among those who perceived a higher level of stigmatization. Results suggest that children affected by HIV may benefit from interventions designed to enhance their capacity to regulate emotions and that health professionals should be aware of the link between stigma and negative emotion in childhood and adolescence and use the knowledge to inform their

Efficacy of computer technology-based HIV prevention interventions: a meta-analysis.

Science.gov (United States)

Noar, Seth M; Black, Hulda G; Pierce, Larson B

2009-01-02

To conduct a meta-analysis of computer technology-based HIV prevention behavioral interventions aimed at increasing condom use among a variety of at-risk populations. Systematic review and meta-analysis of existing published and unpublished studies testing computer-based interventions. Meta-analytic techniques were used to compute and aggregate effect sizes for 12 randomized controlled trials that met inclusion criteria. Variables that had the potential to moderate intervention efficacy were also tested. The overall mean weighted effect size for condom use was d = 0.259 (95% confidence interval = 0.201, 0.317; Z = 8.74, P partners, and incident sexually transmitted diseases. In addition, interventions were significantly more efficacious when they were directed at men or women (versus mixed sex groups), utilized individualized tailoring, used a Stages of Change model, and had more intervention sessions. Computer technology-based HIV prevention interventions have similar efficacy to more traditional human-delivered interventions. Given their low cost to deliver, ability to customize intervention content, and flexible dissemination channels, they hold much promise for the future of HIV prevention.

Surfing Peer-to-Peer IPTV: Distributed Channel Switching

Science.gov (United States)

Kermarrec, A.-M.; Le Merrer, E.; Liu, Y.; Simon, G.

It is now common for IPTV systems attracting millions of users to be based on a peer-to-peer (P2P) architecture. In such systems, each channel is typically associated with one P2P overlay network connecting the users. This significantly enhances the user experience by relieving the source from dealing with all connections. Yet, the joining process resulting in a peer to be integrated in channel overlay usually requires a significant amount of time. As a consequence, switching from one channel to another is far to be as fast as in IPTV solutions provided by telco operators. In this paper, we tackle the issue of efficient channel switching in P2P IPTV system. This is to the best of our knowledge the first study on this topic. First, we conducted and analyzed a set of measurements of one of the most popular P2P systems (PPlive). These measurements reveal that the set of contacts that a joining peer receives from the central server are of the utmost importance in the start-up process. On those neigbors, depends the speed to acquire the first video frames to play. We then formulate the switching problem, and propose a simple distributed algorithm, as an illustration of the concept, which aims at leveraging the presence of peers in the network to fasten the switch process. The principle is that each peer maintains as neighbors peers involved in other channels, providing peers with good contacts upon channel switching. Finally, simulations show that our approach leads to substantial improvements on the channel switching time. As our algorithmic solution does not have any prerequisite on the overlays, it appears to be an appealing add-on for existing P2P IPTV systems.

A Web-Based Peer-Assessment Approach to Improving Junior High School Students' Performance, Self-Efficacy and Motivation in Performing Arts Courses

Science.gov (United States)

Hsia, Lu-Ho; Huang, Iwen; Hwang, Gwo-Jen

2016-01-01

In this paper, a web-based peer-assessment approach is proposed for conducting performing arts activities. A peer-assessment system was implemented and applied to a junior high school performing arts course to evaluate the effectiveness of the proposed approach. A total of 163 junior high students were assigned to an experimental group and a…

Bolstering the Evidence Base for Integrating Abortion and HIV Care: A Literature Review

Directory of Open Access Journals (Sweden)

Ruth Manski

2012-01-01

Full Text Available HIV-positive women have abortions at similar rates to their HIV-negative counterparts, yet little is known about clinical outcomes of abortion for HIV-positive women or the best practices for abortion provision. To fill that gap, we conducted a literature review of clinical outcomes of surgical and medication abortion among HIV-positive women. We identified three studies on clinical outcomes of surgical abortion among HIV-positive women; none showed significant differences in infectious complications by HIV status. A review of seven articles on similar gynecological procedures found no differences in complications by HIV status. No studies evaluated medication abortion among HIV-positive women. However, we did find that previously expressed concerns regarding blood loss and vomiting related to medication abortion for HIV-positive women are unwarranted based on our review of data showing that significant blood loss and vomiting are rare and short lived among women. We conclude that although there is limited research that addresses clinical outcomes of abortion for HIV-positive women, existing data suggest that medication and surgical abortion are safe and appropriate. Sexual and reproductive health and HIV integration efforts must include both options to prevent maternal mortality and morbidity and to ensure that HIV-positive women and women at risk of HIV can make informed reproductive decisions.

Lessons learned from training peer-leaders to conduct Body Project workshops.

Science.gov (United States)

Vanderkruik, Rachel; Strife, Samantha; Dimidjian, Sona

2017-01-01

The Body Project is a cognitive-dissonance intervention that is effective in improving body satisfaction for high school and college aged women. The Body Project can be implemented by trained peers, thus increasing its potential for broad and cost-effective dissemination. Little is known, however, about peer-leaders' perceptions of their training needs and preferences to deliver prevention programs. This qualitative study explored the perceptions of training strengths and areas of improvement among 14 Body Project peer-leaders at a college campus through a series of focus groups. Recommendations are made to inform training for the Body Project as well as peer-led prevention and treatment interventions more broadly.

Evaluation of a task-shifting strategy involving peer educators in HIV care and treatment clinics in Lusaka, Zambia

Directory of Open Access Journals (Sweden)

Lonny J. Born

2012-03-01

Full Text Available Rapid expansion of antiretroviral therapy (ART and a shortage of health care workers (HCWs required the implementation of a peer educator (PE model as part of a task-shifting strategy in Lusaka District clinics. The purpose of this study was to evaluate patient and staff perceptions regarding whether the PE program: a relieved the workload on professional HCWs; and b delivered services of acceptable quality. Qualitative and quantitative data were gathered from five primary care clinics delivering ART in Lusaka, Zambia. Closed surveys were conducted with 148 patients receiving ART, 29 PEs, and 53 HCWs. Data was imported into Microsoft Excel to calculate descriptive statistics. Six focus group discussions and eight key informant (KI interviews were conducted, recorded, transcribed, and coded to extract relevant data. Survey results demonstrated that 50 of 53 (96.1% HCWs agreed PEs reduced the amount of counseling duties required of HCWs. HCWs felt that PEs performed as well as HCWs in counseling patients (48 of 53; 90.6% and that having PEs conduct counseling enabled clinical staff to see more patients (44 of 53; 83%. A majority of patients (141 of 148; 95.2% agreed or strongly agreed that PEs were knowledgeable about ART, and 89 of 144 (61.8% expressed a high level of confidence with PEs performing counseling and related tasks. Focus group and KI interviews supported these findings. PEs helped ease the work burden of HCWs and provided effective counseling, education talks, and adherence support to patients in HIV care. Consideration should be given to formalizing their role in the public health sector.

Knowledge-based society, peer production and the common good

DEFF Research Database (Denmark)

Orsi, Cosma

2009-01-01

This article investigates the societal conditions that might help the establishment of peer-to-peer modes of production. First, the context within which such a new model is emerging - the neoliberal knowledge-based-societies - is described, and its shortcomings unveiled; and second, a robust argu...

HIV screening among TB patients and co-trimoxazole preventive therapy for TB/HIV patients in Addis Ababa: facility based descriptive study.

Science.gov (United States)

Denegetu, Amenu Wesen; Dolamo, Bethabile Lovely

2014-01-01

Collaborative TB/HIV management is essential to ensure that HIV positive TB patients are identified and treated appropriately, and to prevent tuberculosis (TB) in HIV positive patients. The purpose of this study was to assess HIV case finding among TB patients and Co-trimoxazole Preventive Therapy (CPT) for HIV/TB patients in Addis Ababa. A descriptive cross-sectional, facility-based survey was conducted between June and July 2011. Data was collected by interviewing 834 TB patients from ten health facilities in Addis Ababa. Both descriptive and inferential statistics were used to summarize and analyze findings. The proportion of TB patients who (self reported) were offered for HIV test, tested for HIV and tested HIV positive during their anti-TB treatment follow-up were; 87.4%, 69.4% and 20.2%; respectively. Eighty seven HIV positive patients were identified, who knew their status before diagnosed for the current TB disease, bringing the cumulative prevalence of HIV among TB patients to 24.5%. Hence, the proportion of TB patients who knew their HIV status becomes 79.9%. The study revealed that 43.6% of those newly identified HIV positives during anti-TB treatment follow-up were actually treated with CPT. However, the commutative proportion of HIV positive TB patients who were ever treated with CPT was 54.4%; both those treated before the current TB disease and during anti-TB treatment follow-up. HIV case finding among TB patients and provision of CPT for TB/HIV co-infected patients needs boosting. Hence, routine offering of HIV test and provision of CPT for PLHIV should be strengthened in-line with the national guidelines.

Psychometric properties of the Peer Proficiency Assessment (PEPA): a tool for evaluation of undergraduate peer counselors' motivational interviewing fidelity.

Science.gov (United States)

Mastroleo, Nadine R; Mallett, Kimberly A; Turrisi, Rob; Ray, Anne E

2009-09-01

Despite the expanding use of undergraduate student peer counseling interventions aimed at reducing college student drinking, few programs evaluate peer counselors' competency to conduct these interventions. The present research describes the development and psychometric assessments of the Peer Proficiency Assessment (PEPA), a new tool for examining Motivational Interviewing adherence in undergraduate student peer delivered interventions. Twenty peer delivered sessions were evaluated by master and undergraduate student coders using a cross-validation design to examine peer based alcohol intervention sessions. Assessments revealed high inter-rater reliability between student and master coders and good correlations between previously established fidelity tools. Findings lend support for the use of the PEPA to examine peer counselor competency. The PEPA, training for use, inter-rater reliability information, construct and predictive validity, and tool usefulness are described.

Women-specific HIV/AIDS services: identifying and defining the components of holistic service delivery for women living with HIV/AIDS.

Science.gov (United States)

Carter, Allison J; Bourgeois, Sonya; O'Brien, Nadia; Abelsohn, Kira; Tharao, Wangari; Greene, Saara; Margolese, Shari; Kaida, Angela; Sanchez, Margarite; Palmer, Alexis K; Cescon, Angela; de Pokomandy, Alexandra; Loutfy, Mona R

2013-01-11

The increasing proportion of women living with HIV has evoked calls for tailored services that respond to women's specific needs. The objective of this investigation was to explore the concept of women-specific HIV/AIDS services to identify and define what key elements underlie this approach to care. A comprehensive review was conducted using online databases (CSA Social Service Abstracts, OvidSP, Proquest, Psycinfo, PubMed, CINAHL), augmented with a search for grey literature. In total, 84 articles were retrieved and 30 were included for a full review. Of these 30, 15 were specific to HIV/AIDS, 11 for mental health and addictions and four stemmed from other disciplines. The review demonstrated the absence of a consensual definition of women-specific HIV/AIDS services in the literature. We distilled this concept into its defining features and 12 additional dimensions (1) creating an atmosphere of safety, respect and acceptance; (2) facilitating communication and interaction among peers; (3) involving women in the planning, delivery and evaluation of services; (4) providing self-determination opportunities; (5) providing tailored programming for women; (6) facilitating meaningful access to care through the provision of social and supportive services; (7) facilitating access to women-specific and culturally sensitive information; (8) considering family as the unit of intervention; (9) providing multidisciplinary integration and coordination of a comprehensive array of services; (10) meeting women "where they are"; (11) providing gender-, culture- and HIV-sensitive training to health and social care providers; and (12) conducting gendered HIV/AIDS research. This review highlights that the concept of women-specific HIV/AIDS services is a complex and multidimensional one that has been shaped by diverse theoretical perspectives. Further research is needed to better understand this emerging concept and ultimately assess the effectiveness of women-specific services on HIV

Women-specific HIV/AIDS services: identifying and defining the components of holistic service delivery for women living with HIV/AIDS

Science.gov (United States)

Carter, Allison J; Bourgeois, Sonya; O'Brien, Nadia; Abelsohn, Kira; Tharao, Wangari; Greene, Saara; Margolese, Shari; Kaida, Angela; Sanchez, Margarite; Palmer, Alexis K; Cescon, Angela; de Pokomandy, Alexandra; Loutfy, Mona R

2013-01-01

Introduction The increasing proportion of women living with HIV has evoked calls for tailored services that respond to women's specific needs. The objective of this investigation was to explore the concept of women-specific HIV/AIDS services to identify and define what key elements underlie this approach to care. Methods A comprehensive review was conducted using online databases (CSA Social Service Abstracts, OvidSP, Proquest, Psycinfo, PubMed, CINAHL), augmented with a search for grey literature. In total, 84 articles were retrieved and 30 were included for a full review. Of these 30, 15 were specific to HIV/AIDS, 11 for mental health and addictions and four stemmed from other disciplines. Results and discussion The review demonstrated the absence of a consensual definition of women-specific HIV/AIDS services in the literature. We distilled this concept into its defining features and 12 additional dimensions (1) creating an atmosphere of safety, respect and acceptance; (2) facilitating communication and interaction among peers; (3) involving women in the planning, delivery and evaluation of services; (4) providing self-determination opportunities; (5) providing tailored programming for women; (6) facilitating meaningful access to care through the provision of social and supportive services; (7) facilitating access to women-specific and culturally sensitive information; (8) considering family as the unit of intervention; (9) providing multidisciplinary integration and coordination of a comprehensive array of services; (10) meeting women “where they are”; (11) providing gender-, culture- and HIV-sensitive training to health and social care providers; and (12) conducting gendered HIV/AIDS research. Conclusions This review highlights that the concept of women-specific HIV/AIDS services is a complex and multidimensional one that has been shaped by diverse theoretical perspectives. Further research is needed to better understand this emerging concept and ultimately

Undergraduate Essay Writing: Online and Face-to-Face Peer Reviews

Science.gov (United States)

Chong, Mike R.; Goff, Lori; Dej, Kimberly

2012-01-01

We implemented two different approaches of using peer review to support undergraduate essay assignments for students taking large second-year courses in life sciences and biology: a web-based online peer review (OPR) approach and a more traditional face-to-face peer review (FPR) approach that was conducted in tutorial settings. The essays…

Simple Peer-to-Peer SIP Privacy

Science.gov (United States)

Koskela, Joakim; Tarkoma, Sasu

In this paper, we introduce a model for enhancing privacy in peer-to-peer communication systems. The model is based on data obfuscation, preventing intermediate nodes from tracking calls, while still utilizing the shared resources of the peer network. This increases security when moving between untrusted, limited and ad-hoc networks, when the user is forced to rely on peer-to-peer schemes. The model is evaluated using a Host Identity Protocol-based prototype on mobile devices, and is found to provide good privacy, especially when combined with a source address hiding scheme. The contribution of this paper is to present the model and results obtained from its use, including usability considerations.

Controlling HIV Epidemics among Injection Drug Users: Eight Years of Cross-Border HIV Prevention Interventions in Vietnam and China

Science.gov (United States)

Hammett, Theodore M.; Des Jarlais, Don C.; Kling, Ryan; Kieu, Binh Thanh; McNicholl, Janet M.; Wasinrapee, Punneeporn; McDougal, J. Stephen; Liu, Wei; Chen, Yi; Meng, Donghua; Huu Nguyen, Tho; Ngoc Hoang, Quyen; Van Hoang, Tren

2012-01-01

Introduction HIV in Vietnam and Southern China is driven by injection drug use. We have implemented HIV prevention interventions for IDUs since 2002–2003 in Lang Son and Ha Giang Provinces, Vietnam and Ning Ming County (Guangxi), China. Methods Interventions provide peer education and needle/syringe distribution. Evaluation employed serial cross-sectional surveys of IDUs 26 waves from 2002 to 2011, including interviews and HIV testing. Outcomes were HIV risk behaviors, HIV prevalence and incidence. HIV incidence estimation used two methods: 1) among new injectors from prevalence data; and 2) a capture enzyme immunoassay (BED testing) on all HIV+ samples. Results We found significant declines in drug-related risk behaviors and sharp reductions in HIV prevalence among IDUs (Lang Son from 46% to 23% [pHIV incidence to low levels among new injectors through 36–48 months, then some rebound, particularly in Ning Ming, but BED-based estimates revealed significant reductions in incidence through 96 months. Discussion This is one of the longest studies of HIV prevention among IDUs in Asia. The rebound in incidence among new injectors may reflect sexual transmission. BED-based estimates may overstate incidence (because of false-recent results in patients with long-term infection or on ARV treatment) but adjustment for false-recent results and survey responses on duration of infection generally confirm BED-based incidence trends. Combined trends from the two estimation methods show sharp declines in incidence to low levels. The significant downward trends in all primary outcome measures indicate that the Cross-Border interventions played an important role in bringing HIV epidemics among IDUs under control. The Cross-Border project offers a model of HIV prevention for IDUs that should be considered for large-scale replication. PMID:22952640

Association of Internalized and Social Network Level HIV Stigma With High-Risk Condomless Sex Among HIV-Positive African American Men.

Science.gov (United States)

Wagner, Glenn J; Bogart, Laura M; Klein, David J; Green, Harold D; Mutchler, Matt G; McDavitt, Bryce; Hilliard, Charles

2016-08-01

We examined whether internalized HIV stigma and perceived HIV stigma from social network members (alters), including the most popular and most similar alter, predicted condomless intercourse with negative or unknown HIV status partners among 125 African American HIV-positive men. In a prospective, observational study, participants were administered surveys at baseline and months 6 and 12, with measures including sexual behavior, internalized HIV stigma, and an egocentric social network assessment that included several measures of perceived HIV stigma among alters. In longitudinal multivariable models comparing the relative predictive value of internalized stigma versus various measures of alter stigma, significant predictors of having had condomless intercourse included greater internalized HIV stigma (in all models), the perception that a popular (well-connected) alter or alter most like the participant agrees with an HIV stigma belief, and the interaction of network density with having any alter that agrees with a stigma belief. The interaction indicated that the protective effect of greater density (connectedness between alters) in terms of reduced risk behavior dissipated in the presence of perceived alter stigma. These findings call for interventions that help people living with HIV to cope with their diagnosis and reduce stigma, and inform the targets of social network-based and peer-driven HIV prevention interventions.

The complex interplay of social networks, geography and HIV risk among Malaysian Drug Injectors: Results from respondent-driven sampling.

Science.gov (United States)

Zelenev, Alexei; Long, Elisa; Bazazi, Alexander R; Kamarulzaman, Adeeba; Altice, Frederick L

2016-11-01

HIV is primarily concentrated among people who inject drugs (PWID) in Malaysia, where currently HIV prevention and treatment coverage is inadequate. To improve the targeting of interventions, we examined HIV clustering and the role that social networks and geographical distance play in influencing HIV transmission among PWID. Data were derived from a respondent-driven survey sample (RDS) collected during 2010 of 460 PWID in greater Kuala Lumpur. Analysis focused on socio-demographic, clinical, behavioural, and network information. Spatial probit models were developed based on a distinction between the influence of peers (individuals nominated through a recruitment network) and neighbours (residing a close distance to the individual). The models were expanded to account for the potential influence of the network formation. Recruitment patterns of HIV-infected PWID clustered both spatially and across the recruitment networks. In addition, HIV-infected PWID were more likely to have peers and neighbours who inject with clean needles were HIV-infected and lived nearby (applied to identify injection network structures, and this provides an important mechanism for improving public health surveillance, accessing high-risk populations, and implementing risk-reduction interventions to slow HIV transmission. Copyright © 2016 Elsevier B.V. All rights reserved.

Determining a cost effective intervention response to HIV/AIDS in Peru

Science.gov (United States)

Aldridge, Robert W; Iglesias, David; Cáceres, Carlos F; Miranda, J Jaime

2009-01-01

Background The HIV epidemic in Peru is still regarded as concentrated - sentinel surveillance data shows greatest rates of infection in men who have sex with men, while much lower rates are found in female sex workers and still lower in the general population. Without an appropriate set of preventive interventions, continuing infections could present a challenge to the sustainability of the present programme of universal access to treatment. Determining how specific prevention and care strategies would impact on the health of Peruvians should be key in reshaping the national response. Methods HIV/AIDS prevalence levels for risk groups with sufficient sentinel survey data were estimated. Unit costs were calculated for a series of interventions against HIV/AIDS which were subsequently inputted into a model to assess their ability to reduce infection transmission rates. Interventions included: mass media, voluntary counselling and testing; peer counselling for female sex workers; peer counselling for men who have sex with men; peer education of youth in-school; condom provision; STI treatment; prevention of mother to child transmission; and highly active antiretroviral therapy. Impact was assessed by the ability to reduce rates of transmission and quantified in terms of cost per DALY averted. Results Results of the analysis show that in Peru, the highest levels of HIV prevalence are found in men who have sex with men. Cost effectiveness varied greatly between interventions ranging from peer education of female commercial sex workers at $US 55 up to $US 5,928 (per DALY averted) for prevention of mother to child transmission. Conclusion The results of this work add evidence-based clarity as to which interventions warrant greatest consideration when planning an intervention response to HIV in Peru. Cost effectiveness analysis provides a necessary element of transparency when facing choices about priority setting, particularly when the country plans to amplify its

Determining a cost effective intervention response to HIV/AIDS in Peru

Directory of Open Access Journals (Sweden)

Cáceres Carlos F

2009-09-01

Full Text Available Abstract Background The HIV epidemic in Peru is still regarded as concentrated - sentinel surveillance data shows greatest rates of infection in men who have sex with men, while much lower rates are found in female sex workers and still lower in the general population. Without an appropriate set of preventive interventions, continuing infections could present a challenge to the sustainability of the present programme of universal access to treatment. Determining how specific prevention and care strategies would impact on the health of Peruvians should be key in reshaping the national response. Methods HIV/AIDS prevalence levels for risk groups with sufficient sentinel survey data were estimated. Unit costs were calculated for a series of interventions against HIV/AIDS which were subsequently inputted into a model to assess their ability to reduce infection transmission rates. Interventions included: mass media, voluntary counselling and testing; peer counselling for female sex workers; peer counselling for men who have sex with men; peer education of youth in-school; condom provision; STI treatment; prevention of mother to child transmission; and highly active antiretroviral therapy. Impact was assessed by the ability to reduce rates of transmission and quantified in terms of cost per DALY averted. Results Results of the analysis show that in Peru, the highest levels of HIV prevalence are found in men who have sex with men. Cost effectiveness varied greatly between interventions ranging from peer education of female commercial sex workers at $US 55 up to $US 5,928 (per DALY averted for prevention of mother to child transmission. Conclusion The results of this work add evidence-based clarity as to which interventions warrant greatest consideration when planning an intervention response to HIV in Peru. Cost effectiveness analysis provides a necessary element of transparency when facing choices about priority setting, particularly when the country

Context-Specific Associations Between Harsh Parenting and Peer Rejection on Child Conduct Problems at Home and School.

Science.gov (United States)

Tung, Irene; Lee, Steve S

2016-02-06

Although harsh parenting and peer rejection are independently associated with childhood conduct problems (CP), these patterns are often informant specific, suggesting that their associations across contexts (i.e., home and school) should be considered. In a sample of 142 children with and without attention-deficit/hyperactivity disorder (ADHD; ages 5-10; 66% male), we used structural equation modeling to evaluate the structure of multi-informant (parent, teacher) and multimethod (semi-structured interview, questionnaire) rated aggressive, rule-breaking, and oppositional behavior. Next, we explored context-specific associations by modeling harsh parenting and peer rejection as simultaneous and independent predictors of home and school CP. We observed several key findings: (a) the structure of parent- and teacher-reported CP was best accounted by context-specific CP (i.e., home vs. school) and a second-order general CP factor; (b) harsh punishment and peer rejection each independently predicted the second-order general CP factor; and (c) peer rejection was uniquely associated with school CP, whereas harsh punishment was associated only with the second-order general CP factor and did not exhibit specificity with home CP. Whereas harsh parenting and peer rejection were each independently associated with generalized CP, peer rejection showed an additional, unique context-specific association with CP exclusively expressed at school. We discuss potential explanatory mechanisms underlying context-specific associations of CP, as well as address etiological and clinical implications for understanding informant-discrepancies in CP.

Coping with hardship through friendship: the importance of peer ...

African Journals Online (AJOL)

Coping with hardship through friendship: the importance of peer social capital among children affected by HIV in Kenya. ... The children were found to strategically establish formalised friendship groups that ... AJOL African Journals Online.

Perceptions and Experiences about Self-Disclosure of HIV Status among Adolescents with Perinatal Acquired HIV in Poor-Resourced Communities in South Africa.

Science.gov (United States)

Madiba, Sphiwe; Mokgatle, Mathildah

2016-01-01

Background. There is limited research on the disclosure experiences of adolescents with perinatal acquired HIV (PAH). The study explores how adolescents with PAH experience living with HIV and examined their perceptions and experiences regarding disclosure and onward self-disclosure to friends and sexual partners. Methods. Thematic analysis was used to analyze in-depth interviews conducted with 37 adolescents. Findings. Adolescents received disclosure about their status at mean age of 12 years. They perceived disclosure as necessary and appreciated the truthful communication they received. Adolescents have learned to accept and live with HIV, and they desired to be healthy and normal like other people. After receiving disclosure, they found their treatment meaningful, and they adhered to medication. However, they also expressed a strong message that their HIV status was truly their secret and that self-disclosure to others will take the feeling of being normal away from them because they will be treated differently. Conclusion. Adolescents maintained secrecy in order to be accepted by their peers but also to protect themselves from stigma and isolation. Given that adolescents want to be informed of their HIV status but desire controlling self-disclosure of their HIV status, these should form the basis for development of disclosure interventions.

Perceptions and Experiences about Self-Disclosure of HIV Status among Adolescents with Perinatal Acquired HIV in Poor-Resourced Communities in South Africa

Directory of Open Access Journals (Sweden)

Sphiwe Madiba

2016-01-01

Full Text Available Background. There is limited research on the disclosure experiences of adolescents with perinatal acquired HIV (PAH. The study explores how adolescents with PAH experience living with HIV and examined their perceptions and experiences regarding disclosure and onward self-disclosure to friends and sexual partners. Methods. Thematic analysis was used to analyze in-depth interviews conducted with 37 adolescents. Findings. Adolescents received disclosure about their status at mean age of 12 years. They perceived disclosure as necessary and appreciated the truthful communication they received. Adolescents have learned to accept and live with HIV, and they desired to be healthy and normal like other people. After receiving disclosure, they found their treatment meaningful, and they adhered to medication. However, they also expressed a strong message that their HIV status was truly their secret and that self-disclosure to others will take the feeling of being normal away from them because they will be treated differently. Conclusion. Adolescents maintained secrecy in order to be accepted by their peers but also to protect themselves from stigma and isolation. Given that adolescents want to be informed of their HIV status but desire controlling self-disclosure of their HIV status, these should form the basis for development of disclosure interventions.

Passing the baton: Community-based ethnography to design a randomized clinical trial on the effectiveness of oral pre-exposure prophylaxis for HIV prevention among Black men who have sex with men.

Science.gov (United States)

Garcia, Jonathan; Colson, Paul W; Parker, Caroline; Hirsch, Jennifer S

2015-11-01

Although HIV interventions and clinical trials increasingly report the use of mixed methods, studies have not reported on the process through which ethnographic or qualitative findings are incorporated into RCT designs. We conducted a community-based ethnography on social and structural factors that may affect the acceptance of and adherence to oral pre-exposure prophylaxis (PrEP) among Black men who have sex with men (BMSM). We then devised the treatment arm of an adherence clinical trial drawing on findings from the community-based ethnography. This article describes how ethnographic findings informed the RCT and identifies distilled themes and findings that could be included as part of an RCT. The enhanced intervention includes in-person support groups, online support groups, peer navigation, and text message reminders. By describing key process-related facilitators and barriers to conducting meaningful mixed methods research, we provide important insights for the practice of designing clinical trials for 'real-world' community settings. Copyright © 2015 Elsevier Inc. All rights reserved.

Direct provision versus facility collection of HIV self-tests among female sex workers in Uganda: A cluster-randomized controlled health systems trial.

Directory of Open Access Journals (Sweden)

Katrina Ortblad

2017-11-01

Full Text Available HIV self-testing allows HIV testing at any place and time and without health workers. HIV self-testing may thus be particularly useful for female sex workers (FSWs, who should test frequently but face stigma and financial and time barriers when accessing healthcare facilities.We conducted a cluster-randomized controlled health systems trial among FSWs in Kampala, Uganda, to measure the effect of 2 HIV self-testing delivery models on HIV testing and linkage to care outcomes. FSW peer educator groups (1 peer educator and 8 participants were randomized to either (1 direct provision of HIV self-tests, (2 provision of coupons for free collection of HIV self-tests in a healthcare facility, or (3 standard of care HIV testing. We randomized 960 participants in 120 peer educator groups from October 18, 2016, to November 16, 2016. Participants' median age was 28 years (IQR 24-32. Our prespecified primary outcomes were self-report of any HIV testing at 1 month and at 4 months; our prespecified secondary outcomes were self-report of HIV self-test use, seeking HIV-related medical care and ART initiation. In addition, we analyzed 2 secondary outcomes that were not prespecified: self-report of repeat HIV testing-to understand the intervention effects on frequent testing-and self-reported facility-based testing-to quantify substitution effects. Participants in the direct provision arm were significantly more likely to have tested for HIV than those in the standard of care arm, both at 1 month (risk ratio [RR] 1.33, 95% CI 1.17-1.51, p < 0.001 and at 4 months (RR 1.14, 95% CI 1.07-1.22, p < 0.001. Participants in the direct provision arm were also significantly more likely to have tested for HIV than those in the facility collection arm, both at 1 month (RR 1.18, 95% CI 1.07-1.31, p = 0.001 and at 4 months (RR 1.03, 95% CI 1.01-1.05, p = 0.02. At 1 month, fewer participants in the intervention arms had sought medical care for HIV than in the standard of care arm

Engagement with HIV prevention treatment and care among female sex workers in Zimbabwe: a respondent driven sampling survey.

Science.gov (United States)

Cowan, Frances M; Mtetwa, Sibongile; Davey, Calum; Fearon, Elizabeth; Dirawo, Jeffrey; Wong-Gruenwald, Ramona; Ndikudze, Theresa; Chidiya, Samson; Benedikt, Clemens; Busza, Joanna; Hargreaves, James R

2013-01-01

To determine the HIV prevalence and extent of engagement with HIV prevention and care among a representative sample of Zimbabwean sex workers working in Victoria Falls, Hwange and Mutare. Respondent driven sampling (RDS) surveys conducted at each site. Sex workers were recruited using respondent driven sampling with each respondent limited to recruiting 2 peers. Participants completed an interviewer-administered questionnaire and provided a finger prick blood sample for HIV antibody testing. Statistical analysis took account of sampling method. 870 women were recruited from the three sites. HIV prevalence was between 50 and 70%. Around half of those confirmed HIV positive were aware of their HIV status and of those 50-70% reported being enrolled in HIV care programmes. Overall only 25-35% of those with laboratory-confirmed HIV were accessing antiretroviral therapy. Among those reporting they were HIV negative, 21-28% reported having an HIV test in the last 6 months. Of those tested HIV negative, most (65-82%) were unaware of their status. Around two-thirds of sex workers reported consistent condom use with their clients. As in other settings, sex workers reported high rates of gender based violence and police harassment. This survey suggests that prevalence of HIV is high among sex workers in Zimbabwe and that their engagement with prevention, treatment and care is sub-optimal. Intensifying prevention and care interventions for sex workers has the potential to markedly reduce HIV and social risks for sex workers, their clients and the general population in Zimbabwe and elsewhere in the region.

SCI peer health coach influence on self-management with peers: a qualitative analysis.

Science.gov (United States)

Skeels, S E; Pernigotti, D; Houlihan, B V; Belliveau, T; Brody, M; Zazula, J; Hasiotis, S; Seetharama, S; Rosenblum, D; Jette, A

2017-11-01

A process evaluation of a clinical trial. To describe the roles fulfilled by peer health coaches (PHCs) with spinal cord injury (SCI) during a randomized controlled trial research study called 'My Care My Call', a novel telephone-based, peer-led self-management intervention for adults with chronic SCI 1+ years after injury. Connecticut and Greater Boston Area, MA, USA. Directed content analysis was used to qualitatively examine information from 504 tele-coaching calls, conducted with 42 participants with SCI, by two trained SCI PHCs. Self-management was the focus of each 6-month PHC-peer relationship. PHCs documented how and when they used the communication tools (CTs) and information delivery strategies (IDSs) they developed for the intervention. Interaction data were coded and analyzed to determine PHC roles in relation to CT and IDS utilization and application. PHCs performed three principal roles: Role Model, Supporter, and Advisor. Role Model interactions included CTs and IDSs that allowed PHCs to share personal experiences of managing and living with an SCI, including sharing their opinions and advice when appropriate. As Supporters, PHCs used CTs and IDSs to build credible relationships based on dependability and reassuring encouragement. PHCs fulfilled the unique role of Advisor using CTs and IDSs to teach and strategize with peers about SCI self-management. The SCI PHC performs a powerful, flexible role in promoting SCI self-management among peers. Analysis of PHC roles can inform the design of peer-led interventions and highlights the importance for the provision of peer mentor training.

Revised surveillance case definition for HIV infection--United States, 2014.

Science.gov (United States)

2014-04-11

Following extensive consultation and peer review, CDC and the Council of State and Territorial Epidemiologists have revised and combined the surveillance case definitions for human immunodeficiency virus (HIV) infection into a single case definition for persons of all ages (i.e., adults and adolescents aged ≥13 years and children aged case now accommodate new multitest algorithms, including criteria for differentiating between HIV-1 and HIV-2 infection and for recognizing early HIV infection. A confirmed case can be classified in one of five HIV infection stages (0, 1, 2, 3, or unknown); early infection, recognized by a negative HIV test within 6 months of HIV diagnosis, is classified as stage 0, and acquired immunodeficiency syndrome (AIDS) is classified as stage 3. Criteria for stage 3 have been simplified by eliminating the need to differentiate between definitive and presumptive diagnoses of opportunistic illnesses. Clinical (nonlaboratory) criteria for defining a case for surveillance purposes have been made more practical by eliminating the requirement for information about laboratory tests. The surveillance case definition is intended primarily for monitoring the HIV infection burden and planning for prevention and care on a population level, not as a basis for clinical decisions for individual patients. CDC and the Council of State and Territorial Epidemiologists recommend that all states and territories conduct case surveillance of HIV infection using this revised surveillance case definition.

Are cultural values and beliefs included in U.S. based HIV interventions?

Science.gov (United States)

Wyatt, Gail E; Williams, John K; Gupta, Arpana; Malebranche, Dominique

2012-11-01

To determine the extent to which current United States based human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention and risk reduction interventions address and include aspects of cultural beliefs in definitions, curricula, measures and related theories that may contradict current safer sex messages. A comprehensive literature review was conducted to determine which published human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention and risk reduction interventions incorporated aspects of cultural beliefs. This review of 166 human immunodeficiency virus (HIV) prevention and risk reduction interventions, published between 1988 and 2010, identified 34 interventions that varied in cultural definitions and the integration of cultural concepts. human immunodeficiency virus (HIV) interventions need to move beyond targeting specific populations based upon race/ethnicity, gender, sexual, drug and/or risk behaviors and incorporate cultural beliefs and experiences pertinent to an individual's risk. Theory based interventions that incorporate cultural beliefs within a contextual framework are needed if prevention and risk reduction messages are to reach targeted at risk populations. Implications for the lack of uniformity of cultural definitions, measures and related theories are discussed and recommendations are made to ensure that cultural beliefs are acknowledged for their potential conflict with safer sex skills and practices. Copyright © 2011. Published by Elsevier Inc.

Perception and Management of Risk in Internet-Based Peer-to-Peer Milk-Sharing

Science.gov (United States)

Gribble, Karleen D.

2014-01-01

The perception and management of the risks of peer-to-peer milk sharing was explored via a written questionnaire administered to 97 peer milk donors and 41 peer milk recipients who were recruited via Facebook. All recipients' respondents were aware that there were risks associated with using peer-shared milk and took action to mitigate these…

Disclosures of funding sources and conflicts of interest in published HIV/AIDS research conducted in developing countries.

Science.gov (United States)

Klitzman, Robert; Chin, Lisa Judy; Rifai-Bishjawish, Hoda; Kleinert, Kelly; Leu, Cheng-Shiun

2010-08-01

Disclosures of funding sources and conflicts of interests (COI) in published peer-reviewed journal articles have recently begun to receive some attention, but many critical questions remain, for example, how often such reporting occurs concerning research conducted in the developing world and what factors may be involved. Of all articles indexed in Medline reporting on human subject HIV research in 2007 conducted in four countries (India, Thailand, Nigeria and Uganda), this study explored how many disclosed a funding source and COI, and what factors are involved. Of 221 articles that met the criteria, 67.9% (150) disclosed the presence or absence of a funding source, but only 20% (44) disclosed COI. Studies from Uganda were more likely, and those from Nigeria were less likely to mention a funding source (pfunding was more likely when: > or = 50% of the authors and the corresponding author were from the sponsoring country, the sponsor country was the USA, and the articles were published in journals in which more of the editors were from the sponsoring countries. Of the published studies examined, over a third did not disclose funding source (ie, whether or not there was a funding source) and 80% did not disclose whether COI existed. Most articles in ICMJE-affiliated journals did not disclose COI. These data suggest the need to consider alteration of policies to require that published articles include funding and COI information, to allow readers to assess articles as fully as possible.

Implementing HIV/AIDS education: impact of teachers' training on HIV/AIDS education in Bangladesh.

Science.gov (United States)

Sarma, Haribondhu; Oliveras, Elizabeth

2013-03-01

School-based HIV/AIDS education is a common and well-proven intervention strategy for providing information on HIV/AIDS to young people. However, lack of skills among teachers for imparting sensitive information to students can lead to programme failure in terms of achieving goals. A cross-sectional study was conducted among teachers to identify the factors that support or hinder their role in HIV/AIDS education. A self-administered questionnaire was used for interviewing teachers from randomly-selected schools in two adjacent districts in Bangladesh. Based on exposure to teachers' training, the districts were divided into control and intervention areas and the teachers' ability, skill, and their participation in HIV/AIDS education were compared between the districts. Trained teachers in the intervention schools were more likely to participate, less likely to face difficulties, and more likely to use interactive teaching methods in HIV/ AIDS classes compared to the controls who did not receive any training. Inadequate allocation of time for conducting the HIV/AIDS class was found to be barriers to HIV/AIDS education that suggest the need to provide teachers with more support in terms of training and logistics.

Challenging dominant norms of masculinity for HIV prevention.

Science.gov (United States)

MacPhail, Catherine

2003-01-01

Within South Africa there is a growing HIV epidemic, particularly among young heterosexual people. A recent report (NMF/HSRC, 2002) indicates that levels of HIV infection among young people aged 15-24 years are 9.3% although other studies in more specific locations have shown levels to be higher than this. One of the best means of developing successful and innovative HIV prevention programmes for young people is to enhance our understandings of youth sexuality and the manner in which dominant norms contribute to the spread of sexually transmitted diseases. Social norms of masculinity are particularly important in this regard, as the manner in which 'normal' men are defined such as through acquisition of multiple partners, power over women and negative attitudes towards condoms, are often in conflict with the true emotional vulnerabilities of young men. Given the strong influence of peer groups on young people and the belief that one of the solutions to behaviour change lies in peer renegotiation of dominant norms, there is the need to begin to investigate young men who challenge dominant norms of masculinity. It is in investigating their points of view that a platform for the deconstruction of stereotypical masculinities and the reconstruction of new norms can be formed. The paper begins to consider these counter normative ideas through highlighting the discussions of young South African men aged 13-25 years in focus groups and in-depth individual interviews conducted in Gauteng Province. It is apparent that among this group there are young men challenging normative views of masculinity in a manner that could be harnessed within HIV prevention initiatives.

A taxonomy for community-based care programs focused on HIV/AIDS prevention, treatment, and care in resource-poor settings

Directory of Open Access Journals (Sweden)

Beth Rachlis

2013-04-01

Full Text Available Community-based care (CBC can increase access to key services for people affected by HIV/AIDS through the mobilization of community interests and resources and their integration with formal health structures. Yet, the lack of a systematic framework for analysis of CBC focused on HIV/AIDS impedes our ability to understand and study CBC programs. We sought to develop taxonomy of CBC programs focused on HIV/AIDS in resource-limited settings in an effort to understand their key characteristics, uncover any gaps in programming, and highlight the potential roles they play. Our review aimed to systematically identify key CBC programs focused on HIV/AIDS in resource-limited settings. We used both bibliographic database searches (Medline, CINAHL, and EMBASE for peer-reviewed literature and internet-based searches for gray literature. Our search terms were ‘HIV’ or ‘AIDS’ and ‘community-based care’ or ‘CBC’. Two co-authors developed a descriptive taxonomy through an iterative, inductive process using the retrieved program information. We identified 21 CBC programs useful for developing taxonomy. Extensive variation was observed within each of the nine categories identified: region, vision, characteristics of target populations, program scope, program operations, funding models, human resources, sustainability, and monitoring and evaluation strategies. While additional research may still be needed to identify the conditions that lead to overall program success, our findings can help to inform our understanding of the various aspects of CBC programs and inform potential logic models for CBC programming in the context of HIV/AIDS in resource-limited settings. Importantly, the findings of the present study can be used to develop sustainable HIV/AIDS-service delivery programs in regions with health resource shortages.

Selective elimination of HIV-1-infected cells by Env-directed, HIV-1-based virus-like particles

International Nuclear Information System (INIS)

Peretti, Silvia; Schiavoni, Ilaria; Pugliese, Katherina; Federico, Maurizio

2006-01-01

We recently showed that both replicating and resting cells cultivated with ganciclovir (GCV) were killed when challenged with vesicular stomatitis virus G glycoprotein pseudotyped HIV-1-based virus-like particles (VLPs) carrying the Nef7 (i.e., an HIV-1 Nef mutant incorporating in virions at high levels)/herpes simplex virus-1 thymidine kinase (HSV-TK) fusion product. On this basis, a novel anti-HIV therapeutic approach based on Nef7/TK VLPs expressing X4 or R5 HIV cell receptor complexes has been attempted. We here report that (CD4-CXCR4) and (CD4-CCR5) Nef7-based VLPs efficiently enter cells infected by X4- or R5-tropic HIV-1 strains, respectively. Importantly, the delivery of the VLP-associated Nef7/TK led to cell death upon GCV treatment. Of interest, VLPs were effective also against non-replicating, HIV-1-infected primary human monocyte-derived macrophages. HIV-targeted VLPs represent a promising candidate for the treatment of persistently HIV-1-infected cells that are part of virus reservoirs resistant to HAART therapies

Myths, science and stories: working with peer educators to counter ...

African Journals Online (AJOL)

Open Access DOWNLOAD FULL TEXT Subscription or Fee Access ... Keywords: action research, communication, health education, HIV/AIDS education, peer education, South Africa, storytelling, workplace. African Journal of AIDS Research ...

Particle-based vaccines for HIV-1 infection.

Science.gov (United States)

Young, Kelly R; Ross, Ted M

2003-06-01

The use of live-attenuated viruses as vaccines has been successful for the control of viral infections. However, the development of an effective vaccine against the human immunodeficiency virus (HIV) has proven to be a challenge. HIV infects cells of the immune system and results in a severe immunodeficiency. In addition, the ability of the virus to adapt to immune pressure and the ability to reside in an integrated form in host cells present hurdles for vaccinologists to overcome. A particle-based vaccine strategy has promise for eliciting high titer, long-lived, immune responses to a diverse number of viral epitopes from different HIV antigens. Live-attenuated viruses are effective at generating both cellular and humoral immunity, however, a live-attenuated vaccine for HIV is problematic. The possibility of a live-attenuated vaccine to revert to a pathogenic form or recombine with a wild-type or defective virus in an infected individual is a drawback to this approach. Therefore, these vaccines are currently only being tested in non-human primate models. Live-attenuated vaccines are effective in stimulating immunity, however challenged animals rarely clear viral infection and the degree of attenuation directly correlates with the protection of animals from disease. Another particle-based vaccine approach for HIV involves the use of virus-like particles (VLPs). VLPs mimic the viral particle without causing an immunodeficiency disease. HIV-like particles (HIV-LP) are defined as self-assembling, non-replicating, nonpathogenic, genomeless particles that are similar in size and conformation to intact virions. A variety of VLPs for both HIV and SIV are currently in pre-clinical and clinical trials. This review focuses on the current knowledge regarding the immunogenicity and safety of particle-based vaccine strategies for HIV-1.

A Web-based Peer Assessment System for Assigning Student Scores in Cooperative Learning

Directory of Open Access Journals (Sweden)

Anon Sukstrienwong

2017-11-01

Full Text Available Working in groups has become increasingly important in order to develop students' skills. However, it can be more successful when peers cooperate and are involved in the assigned tasks. However, several educators firmly show disadvantages when all peers received the same reward, regardless of individual contribution. Some teachers also considering peer assessment to be time and effort consuming because preparation and monitoring are needed. In order to overcome these problems, we have developed a web-based peer assessment referred to as the ‘Scoring by Peer Assessment System’ (SPAS that allows teachers to set up the process of peer assessment, in order to assign scores that reflect the contribution of each student. Moreover, a web-based application allows students to evaluate their peers regarding their individual contribution where cooperative learning and peer assessment are used. The paper describes the system design and the implementation of our peer assessment application.

Barriers and facilitators to HIV testing among young men who have sex with men and transgender women in Kingston, Jamaica: a qualitative study.

Science.gov (United States)

Logie, Carmen H; Lacombe-Duncan, Ashley; Brien, Natasha; Jones, Nicolette; Lee-Foon, Nakia; Levermore, Kandasi; Marshall, Annecka; Nyblade, Laura; Newman, Peter A

2017-04-04

Young men who have sex with men (MSM) in Jamaica have the highest HIV prevalence in the Caribbean. There is little information about HIV among transgender women in Jamaica, who are also overrepresented in the Caribbean epidemic. HIV-related stigma is a barrier to HIV testing among Jamaica's general population, yet little is known of MSM and transgender women's HIV testing experiences in Jamaica. We explored perceived barriers and facilitators to HIV testing among young MSM and transgender women in Kingston, Jamaica. We implemented a community-based research project in collaboration with HIV and lesbian, gay, bisexual and transgender (LGBT) agencies in Kingston. We held two focus groups, one with young (aged 18-30 years) transgender women (n = 8) and one with young MSM (n = 10). We conducted 53 in-depth individual semi-structured interviews focused on HIV testing experiences with young MSM (n = 20), transgender women (n = 20), and community-based key informants (n = 13). We conducted thematic analysis to identify, analyze, and report themes. Participant narratives revealed social-ecological barriers and facilitators to HIV testing. Barriers included healthcare provider mistreatment, confidentiality breaches, and HIV-related stigma: these spanned interpersonal, community and structural levels. Healthcare provider discrimination and judgment in HIV testing provision presented barriers to accessing HIV services (e.g. treatment), and resulted in participants hiding their sexual orientation and/or gender identity. Confidentiality concerns included: clinic physical arrangements that segregated HIV testing from other health services, fear that healthcare providers would publicly disclose their status, and concerns at LGBT-friendly clinics that peers would discover they were getting tested. HIV-related stigma contributed to fear of testing HIV-positive; this intersected with the stigma of HIV as a "gay" disease. Participants also anticipated healthcare provider

HyperPeer

DEFF Research Database (Denmark)

Larsen, R.D.; Bouvin, N.O.

2004-01-01

This paper presents HyperPeer, a framework for developing peer-to-peer based hypermedia. The distribution of hypermedia structures is handled through a peer-to-peer (P2P) network, allowing for highly scalable sharing between users. A central challenge of all decentralized systems is to locate...

Problem-based, peer-to-peer global mental health e-learning between the UK and Somaliland: a pilot study.

Science.gov (United States)

Murphy, Roberta; Clissold, Elliot; Keynejad, Roxanne C

2017-11-01

WHO's mental health gap action programme intervention guide (mhGAP-IG) is an evidence-based tool aimed at front-line health workers in low-income and middle-income countries (LMICs). Its potential to improve global mental health education, especially through digital technologies, has been little studied. Problem-based learning (PBL) is usually conducted face-to-face, but its remote application could facilitate cross-cultural education. To evaluate PBL, applied to peer-to-peer global mental health e-learning (Aqoon), using mhGAP-IG. Twelve pairs of UK and Somaliland medical students completed the full programme. Participants self-directedly met online, via the low-bandwidth Medicine Africa website, for PBL-style tutorials focused on modules of the mhGAP-IG, V.2.0. Preparticipation and postparticipation surveys used mixed methods to evaluate Aqoon, including the Attitudes Toward Psychiatry (ATP-30) instrument. Median ATP-30 scores for Somaliland (82.0 vs 95.0, p=0.003) and UK students (82.0 vs 95.0, p = 0.011) improved significantly following Aqoon. Qualitative feedback showed that participants valued peer connectivity and learning about cultural and psychosocial differences in their partner's country. Somaliland students were motivated by clinical learning and UK students by global health education. Feedback on the PBL structure was positive. Digital PBL represents an innovative method to extend the benefits of mhGAP-IG beyond front-line clinical staff, to healthcare students in LMICs. Educational resource limitations in LMICs may be overcome using digital platforms and PBL. Replication with non-medical healthcare students is the next step for this model to explore Aqoon's relevance to pressing global mental health workforce challenges. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Peer Feedback to Facilitate Project-Based Learning in an Online Environment

Science.gov (United States)

Ching, Yu-Hui; Hsu, Yu-Chang

2013-01-01

There has been limited research examining the pedagogical benefits of peer feedback for facilitating project-based learning in an online environment. Using a mixed method approach, this paper examines graduate students' participation and perceptions of peer feedback activity that supports project-based learning in an online instructional design…

Faith and HIV prevention: the conceptual framing of HIV prevention among Pentecostal Batswana teenagers.

Science.gov (United States)

Mpofu, Elias; Nkomazana, Fidelis; Muchado, Jabulani A; Togarasei, Lovemore; Bingenheimer, Jeffrey Bart

2014-03-05

There is a huge interest by faith-based organizations (FBOs) in sub-Saharan Africa and elsewhere in HIV prevention interventions that build on the religious aspects of being. Successful partnerships between the public health services and FBOs will require a better understanding of the conceptual framing of HIV prevention by FBOS to access for prevention intervention, those concepts the churches of various denominations and their members would support or endorse. This study investigated the conceptual framing of HIV prevention among church youths in Botswana;--a country with one of the highest HIV prevalence in the world. Participants were 213 Pentecostal church members (67% female; age range 12 to 23 years; median age=19 years). We engaged the participants in a mixed-method inductive process to collect data on their implicit framing of HIV prevention concepts, taking into account the centrality of religion concepts to them and the moderating influences of age, gender and sexual experience. After, we analysed the data using multi-dimensional scaling (MDS) and hierarchical cluster analysis (HCA) to map the ways the church youths framed HIV prevention. The findings suggest the church youth to conceptually frame their HIV prevention from both faith-oriented and secular-oriented perspectives, while prioritizing the faith-oriented concepts based on biblical teachings and future focus. In their secular-oriented framing of HIV prevention, the church youths endorsed the importance to learn the facts about HIV and AIDS, understanding of community norms that increased risk for HIV and prevention education. However, components of secular-oriented framing of HIV prevention concepts were comparatively less was well differentiated among the youths than with faith-oriented framing, suggesting latent influences of the church knowledge environment to undervalue secular oriented concepts. Older and sexually experienced church youths in their framing of HIV prevention valued future

Promoting the uptake of HIV testing among men who have sex with men: systematic review of effectiveness and cost-effectiveness.

Science.gov (United States)

Lorenc, Theo; Marrero-Guillamón, Isaac; Aggleton, Peter; Cooper, Chris; Llewellyn, Alexis; Lehmann, Angela; Lindsay, Catriona

2011-06-01

What interventions are effective and cost-effective in increasing the uptake of HIV testing among men who have sex with men (MSM)? A systematic review was conducted of the following databases: AEGIS, ASSIA, BL Direct, BNI, Centre for Reviews and Dissemination, Cochrane Database of Systematic Reviews, CINAHL, Current Contents Connect, EconLit, EMBASE, ERIC, HMIC, Medline, Medline In-Process, NRR, PsychINFO, Scopus, SIGLE, Social Policy and Practice, Web of Science, websites, journal hand-searching, citation chasing and expert recommendations. Prospective studies of the effectiveness or cost-effectiveness of interventions (randomised controlled trial (RCT), controlled trial, one-group or any economic analysis) were included if the intervention aimed to increase the uptake of HIV testing among MSM in a high-income (Organization for Economic Co-operation and Development) country. Quality was assessed and data were extracted using standardised tools. Results were synthesised narratively. Twelve effectiveness studies and one cost-effectiveness study were located, covering a range of intervention types. There is evidence that rapid testing and counselling in community settings (one RCT), and intensive peer counselling (one RCT), can increase the uptake of HIV testing among MSM. There are promising results regarding the introduction of opt-out testing in sexually transmitted infection clinics (two one-group studies). Findings regarding other interventions, including bundling HIV tests with other tests, peer outreach in community settings, and media campaigns, are inconclusive. Findings indicate several promising approaches to increasing HIV testing among MSM. However, there is limited evidence overall, and evidence for the effectiveness of key intervention types (particularly peer outreach and media campaigns) remains lacking.

Achieving universal access and moving towards elimination of new HIV infections in Cambodia

Science.gov (United States)

Vun, Mean Chhi; Fujita, Masami; Rathavy, Tung; Eang, Mao Tang; Sopheap, Seng; Sovannarith, Samreth; Chhorvann, Chhea; Vanthy, Ly; Sopheap, Oum; Welle, Emily; Ferradini, Laurent; Sedtha, Chin; Bunna, Sok; Verbruggen, Robert

2014-01-01

Introduction In the mid-1990s, Cambodia faced one of the fastest growing HIV epidemics in Asia. For its achievement in reversing this trend, and achieving universal access to HIV treatment, the country received a United Nations millennium development goal award in 2010. This article reviews Cambodia’s response to HIV over the past two decades and discusses its current efforts towards elimination of new HIV infections. Methods A literature review of published and unpublished documents, including programme data and presentations, was conducted. Results and discussion Cambodia classifies its response to one of the most serious HIV epidemics in Asia into three phases. In Phase I (1991–2000), when adult HIV prevalence peaked at 1.7% and incidence exceeded 20,000 cases, a nationwide HIV prevention programme targeted brothel-based sex work. Voluntary confidential counselling and testing and home-based care were introduced, and peer support groups of people living with HIV emerged. Phase II (2001–2011) observed a steady decline in adult prevalence to 0.8% and incidence to 1600 cases by 2011, and was characterized by: expanding antiretroviral treatment (coverage reaching more than 80%) and continuum of care; linking with tuberculosis and maternal and child health services; accelerated prevention among key populations, including entertainment establishment-based sex workers, men having sex with men, transgender persons, and people who inject drugs; engagement of health workers to deliver quality services; and strengthening health service delivery systems. The third phase (2012–2020) aims to attain zero new infections by 2020 through: sharpening responses to key populations at higher risk; maximizing access to community and facility-based testing and retention in prevention and care; and accelerating the transition from vertical approaches to linked/integrated approaches. Conclusions Cambodia has tailored its prevention strategy to its own epidemic, established

HIV/AIDS Prevention Activities of Faith-Based Christian ...

African Journals Online (AJOL)

Based on these findings, it was recommended that the faith-based Christian organizations should collaborate with relevant agencies, community based workers and non-formal education providers to improve HIV/AIDS prevention service delivery in the study area. Keywords: Prevention, Activities, HIV/AIDS, Empowerment, ...

Ensuring an optimal environment for peer education in South African schools: Goals, systems, standards and policy options for effective learning.

Science.gov (United States)

Swartz, Sharlene; Deutsch, Charles; Moolman, Benita; Arogundade, Emma; Isaacs, Dane; Michel, Barbara

2016-12-01

Peer education has long been seen as a key health promotion strategy and an important tool in preventing HIV infection. In South African schools, it is currently one of the strategies employed to do so. Based on both a recent research study of peer education across 35 schools and drawing on multiple previous studies in South Africa, this paper examines the key elements of peer education that contribute to its effectiveness and asks how this aligns with current educational and health policies. From this research, it summarises and proposes shared goals and aims, minimum standards of implementation and reflects on the necessary infrastructure required for peer education to be effective. In light of these findings, it offers policy recommendations regarding who should be doing peer education and the status peer education should have in a school's formal programme.

HIV self-testing among female sex workers in Zambia: A cluster randomized controlled trial.

Directory of Open Access Journals (Sweden)

Michael M Chanda

2017-11-01

Full Text Available HIV self-testing (HIVST may play a role in addressing gaps in HIV testing coverage and as an entry point for HIV prevention services. We conducted a cluster randomized trial of 2 HIVST distribution mechanisms compared to the standard of care among female sex workers (FSWs in Zambia.Trained peer educators in Kapiri Mposhi, Chirundu, and Livingstone, Zambia, each recruited 6 FSW participants. Peer educator-FSW groups were randomized to 1 of 3 arms: (1 delivery (direct distribution of an oral HIVST from the peer educator, (2 coupon (a coupon for collection of an oral HIVST from a health clinic/pharmacy, or (3 standard-of-care HIV testing. Participants in the 2 HIVST arms received 2 kits: 1 at baseline and 1 at 10 weeks. The primary outcome was any self-reported HIV testing in the past month at the 1- and 4-month visits, as HIVST can replace other types of HIV testing. Secondary outcomes included linkage to care, HIVST use in the HIVST arms, and adverse events. Participants completed questionnaires at 1 and 4 months following peer educator interventions. In all, 965 participants were enrolled between September 16 and October 12, 2016 (delivery, N = 316; coupon, N = 329; standard of care, N = 320; 20% had never tested for HIV. Overall HIV testing at 1 month was 94.9% in the delivery arm, 84.4% in the coupon arm, and 88.5% in the standard-of-care arm (delivery versus standard of care risk ratio [RR] = 1.07, 95% CI 0.99-1.15, P = 0.10; coupon versus standard of care RR = 0.95, 95% CI 0.86-1.05, P = 0.29; delivery versus coupon RR = 1.13, 95% CI 1.04-1.22, P = 0.005. Four-month rates were 84.1% for the delivery arm, 79.8% for the coupon arm, and 75.1% for the standard-of-care arm (delivery versus standard of care RR = 1.11, 95% CI 0.98-1.27, P = 0.11; coupon versus standard of care RR = 1.06, 95% CI 0.92-1.22, P = 0.42; delivery versus coupon RR = 1.05, 95% CI 0.94-1.18, P = 0.40. At 1 month, the majority of HIV tests were self-tests (88.4%. HIV self

HIV self-testing among female sex workers in Zambia: A cluster randomized controlled trial.

Science.gov (United States)

Chanda, Michael M; Ortblad, Katrina F; Mwale, Magdalene; Chongo, Steven; Kanchele, Catherine; Kamungoma, Nyambe; Fullem, Andrew; Dunn, Caitlin; Barresi, Leah G; Harling, Guy; Bärnighausen, Till; Oldenburg, Catherine E

2017-11-01

HIV self-testing (HIVST) may play a role in addressing gaps in HIV testing coverage and as an entry point for HIV prevention services. We conducted a cluster randomized trial of 2 HIVST distribution mechanisms compared to the standard of care among female sex workers (FSWs) in Zambia. Trained peer educators in Kapiri Mposhi, Chirundu, and Livingstone, Zambia, each recruited 6 FSW participants. Peer educator-FSW groups were randomized to 1 of 3 arms: (1) delivery (direct distribution of an oral HIVST from the peer educator), (2) coupon (a coupon for collection of an oral HIVST from a health clinic/pharmacy), or (3) standard-of-care HIV testing. Participants in the 2 HIVST arms received 2 kits: 1 at baseline and 1 at 10 weeks. The primary outcome was any self-reported HIV testing in the past month at the 1- and 4-month visits, as HIVST can replace other types of HIV testing. Secondary outcomes included linkage to care, HIVST use in the HIVST arms, and adverse events. Participants completed questionnaires at 1 and 4 months following peer educator interventions. In all, 965 participants were enrolled between September 16 and October 12, 2016 (delivery, N = 316; coupon, N = 329; standard of care, N = 320); 20% had never tested for HIV. Overall HIV testing at 1 month was 94.9% in the delivery arm, 84.4% in the coupon arm, and 88.5% in the standard-of-care arm (delivery versus standard of care risk ratio [RR] = 1.07, 95% CI 0.99-1.15, P = 0.10; coupon versus standard of care RR = 0.95, 95% CI 0.86-1.05, P = 0.29; delivery versus coupon RR = 1.13, 95% CI 1.04-1.22, P = 0.005). Four-month rates were 84.1% for the delivery arm, 79.8% for the coupon arm, and 75.1% for the standard-of-care arm (delivery versus standard of care RR = 1.11, 95% CI 0.98-1.27, P = 0.11; coupon versus standard of care RR = 1.06, 95% CI 0.92-1.22, P = 0.42; delivery versus coupon RR = 1.05, 95% CI 0.94-1.18, P = 0.40). At 1 month, the majority of HIV tests were self-tests (88.4%). HIV self-test use

Peer Support in Full-Service Partnerships: A Multiple Case Study Analysis.

Science.gov (United States)

Siantz, Elizabeth; Henwood, Benjamin; Gilmer, Todd

2017-07-01

Peer providers are integral to Full Service Partnerships (FSPs), which are team-based mental health service models. Peer providers use principles of recovery to engage clients, but FSPs can vary in their recovery orientation. Whether and how peer recovery orientation reflects the organizational environments of FSPs is unclear. This qualitative study explored peer provider attitudes towards recovery within the organizational contexts of FSPs where they are employed. Case study analysis was conducted on eight purposively sampled FSPs using qualitative interviews with peer providers and program directors. In two cases, peer recovery attitudes diverged from those of their organizational context. In these cases, peer providers were champions for recovery, and used practice-based strategies to promote client autonomy despite working in settings with lower recovery orientation. Peer providers could be uniquely positioned to promote client autonomy in settings where organizational factors limit consumer choice.

Vijana Vijiweni II: a cluster-randomized trial to evaluate the efficacy of a microfinance and peer health leadership intervention for HIV and intimate partner violence prevention among social networks of young men in Dar es Salaam.

Science.gov (United States)

Kajula, Lusajo; Balvanz, Peter; Kilonzo, Mrema Noel; Mwikoko, Gema; Yamanis, Thespina; Mulawa, Marta; Kajuna, Deus; Hill, Lauren; Conserve, Donaldson; Reyes, Heathe Luz McNaughton; Leatherman, Sheila; Singh, Basant; Maman, Suzanne

2016-02-03

Intimate partner violence (IPV) and sexually transmitted infections (STIs), including HIV, remain important public health problems with devastating health effects for men and women in sub-Saharan Africa. There have been calls to engage men in prevention efforts, however, we lack effective approaches to reach and engage them. Social network approaches have demonstrated effective and sustained outcomes on changing risk behaviors in the U.S. Our team has identified and engaged naturally occurring social networks comprised mostly of young men in Dar es Salaam in an intervention designed to jointly reduce STI incidence and the perpetration of IPV. These stable networks are locally referred to as "camps." In a pilot study we demonstrated the feasibility and acceptability of a combined microfinance and peer health leadership intervention within these camp-based peer networks. We are implementing a cluster-randomized trial to evaluate the efficacy of an intervention combining microfinance with health leadership training in 60 camps in Dar es Salaam, Tanzania. Half of the camps have been randomized to the intervention arm, and half to a control arm. The camps in the intervention arm will receive a combined microfinance and health leadership intervention for a period of two years. The camps in the control arm will receive a delayed intervention. We have enrolled 1,258 men across the 60 study camps. Behavioral surveys will be conducted at baseline, 12-months post intervention launch and 30-month post intervention launch and biological samples will be drawn to test for Neisseria gonorrhea (NG), Chlamydia trachomatis (CT), and Trichomonas vaginalis (TV) at baseline and 30-months. The primary endpoints for assessing intervention impact are IPV perpetration and STI incidence. This is the first cluster-randomized trial targeting social networks of men in sub-Saharan Africa that jointly addresses HIV and IPV perpetration and has both biological and behavioral endpoints. Effective

War-Related Abduction and History of Incarceration Linked to High Burden of HIV Among Female Sex Workers in Conflict-Affected Northern Uganda.

Science.gov (United States)

Goldenberg, Shira M; Muzaaya, Godfrey; Akello, Monica; Nguyen, Paul; Birungi, Josephine; Shannon, Kate

2016-09-01

Sex workers (SWs) in sub-Saharan Africa face a disproportionate HIV burden and growing concerns of severe human rights violations. Given the dearth of evidence on the burden and correlates of HIV among SWs in sub-Saharan Africa, particularly within conflict-affected settings, we examined the relationship between structural determinants (eg, war-related abduction, incarceration) and HIV infection among conflict-affected SWs in Northern Uganda. Cross-sectional community-based research study among female SWs in conflict-affected Gulu, Northern Uganda. Interview questionnaires and voluntary HIV testing were conducted with participants recruited through SW/peer-led outreach and time-location sampling from 2011 to 2012. HIV prevalence was calculated, and bivariable and multivariable logistic regression was used to identify independent associations with HIV seroprevalence. Of 400 SWs, 135 (33.75%) were HIV seropositive; of whom one-third were new/previously undiagnosed HIV infections. In multivariable analysis, after adjusting for age of sex work entry and education, lifetime incarceration (adjusted odds ratio: 1.93, 95% confidence interval: 1.17 to -3.20) was independently associated with HIV seroprevalence, and history of wartime abduction (adjusted odds ratio: 1.62, 95% confidence interval: 1.00 to 2.63) was marginally associated (P = 0.051). This study documented a high rate of undiagnosed HIV infections and associations between war-related human rights violations, incarceration, and a heavy HIV burden among SWs in conflict-affected Northern Uganda. These findings highlight the serious harms of conflict and criminalization of marginalized women in sub-Saharan African contexts. SW-led interventions that address conflict experiences and policy shifts to promote a rights-based approach to HIV prevention and care remain critically needed.

Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases.

Science.gov (United States)

Swendeman, Dallas; Basu, Ishika; Das, Sankari; Jana, Smarajit; Rotheram-Borus, Mary Jane

2009-10-01

The Sonagachi Project was initiated in Kolkata, India in 1992 as a STD/HIV intervention for sex workers. The project evolved to adopt strategies common to women's empowerment programs globally (i.e., community mobilization, rights-based framing, advocacy, micro-finance) to address common factors that support effective, evidence-based HIV/STD prevention. The Sonagachi model is now a broadly diffused evidence-based empowerment program. We previously demonstrated significant condom use increases among female sex workers in a 16 month replication trial of the Sonagachi empowerment intervention (n=110) compared to a control community (n=106) receiving standard care of STD clinic, condom promotion, and peer education in two randomly assigned rural towns in West Bengal, India (Basu et al., 2004). This article examines the intervention's impacts on 21 measured variables reflecting five common factors of effective HIV/STD prevention programs to estimate the impact of empowerment strategies on HIV/STD prevention program goals. The intervention which was conducted in 2000-2001 significantly: 1) improved knowledge of STDs and condom protection from STD and HIV, and maintained STD/HIV risk perceptions despite treatment; 2) provided a frame to motivate change based on reframing sex work as valid work, increasing disclosure of profession, and instilling a hopeful future orientation reflected in desire for more education or training; 3) improved skills in sexual and workplace negotiations reflected in increased refusal, condom decision-making, and ability to change work contract, but not ability to take leave; 4) built social support by increasing social interactions outside work, social function participation, and helping other sex workers; and 5) addressed environmental barriers of economic vulnerabilities by increasing savings and alternative income, but not working in other locations, nor reduced loan taking, and did not increase voting to build social capital. This study

Perceived peer influence and peer selection on adolescent smoking.

Science.gov (United States)

Hoffman, Beth R; Monge, Peter R; Chou, Chih-Ping; Valente, Thomas W

2007-08-01

Despite advances in tobacco control, adolescent smoking remains a problem. The smoking status of friends is one of the highest correlates with adolescent smoking. This homophily (commonality of friends based on a given attribute) may be due to either peer pressure, where adolescents adopt the smoking behaviors of their friends, or peer selection, where adolescents choose friends based on their smoking status. This study used structural equation modeling to test a model of peer influence and peer selection on ever smoking by adolescents. The primary analysis of the model did not reach significance, but post hoc analyses did result in a model with good fit. Results indicated that both peer influence and peer selection were occurring, and that peer influence was more salient in the population than was peer selection. Implications of these results for tobacco prevention programs are discussed.

Enhancing the prospective biology teachers’ Pedagogical Content Knowledge (PCK) through a peer coaching based model

Science.gov (United States)

Anwar, Yenny

2018-05-01

This paper presents the results of implementation Peer Coaching Based Model that was implemented in development and Packaging Learning Tool program aimed at developing a Pedagogical Content Knowledge prospective teachers’ capabilities. Development and Packaging Learning Tool is a training program that applies various knowledge, attitude, and skill of students in order to form professional teacher. A need assessment was conducted to identify prospective teachers’ professional needs, especially PCK ability. Tests, questionnaires, interviews, field notes and video recordings were used in this research. The result indicated that the ability of Prospective teachers’ PCK has increased. This can be shown from the N-Gain that included in the medium category. This increase shows that there is integration of pedagogy and content; they have used varied strategies and can explain the reasons for its used. This means that the pattern belongs to the lower limit of the growing- PCK category. It is recommended to use peer coaching model during peer teaching.

Peer-to-peer mentoring for individuals with early inflammatory arthritis: feasibility pilot.

Science.gov (United States)

Sandhu, Sharron; Veinot, Paula; Embuldeniya, Gayathri; Brooks, Sydney; Sale, Joanna; Huang, Sicong; Zhao, Alex; Richards, Dawn; Bell, Mary J

2013-03-01

To examine the feasibility and potential benefits of early peer support to improve the health and quality of life of individuals with early inflammatory arthritis (EIA). Feasibility study using the 2008 Medical Research Council framework as a theoretical basis. A literature review, environmental scan, and interviews with patients, families and healthcare providers guided the development of peer mentor training sessions and a peer-to-peer mentoring programme. Peer mentors were trained and paired with a mentee to receive (face-to-face or telephone) support over 12 weeks. Two academic teaching hospitals in Toronto, Ontario, Canada. Nine pairs consisting of one peer mentor and one mentee were matched based on factors such as age and work status. Mentee outcomes of disease modifying antirheumatic drugs (DMARDs)/biological treatment use, self-efficacy, self-management, health-related quality of life, anxiety, coping efficacy, social support and disease activity were measured using validated tools. Descriptive statistics and effect sizes were calculated to determine clinically important (>0.3) changes. Peer mentor self-efficacy was assessed using a self-efficacy scale. Interviews conducted with participants examined acceptability and feasibility of procedures and outcome measures, as well as perspectives on the value of peer support for individuals with EIA. Themes were identified through constant comparison. Mentees experienced improvements in the overall arthritis impact on life, coping efficacy and social support (effect size >0.3). Mentees also perceived emotional, informational, appraisal and instrumental support. Mentors also reported benefits and learnt from mentees' fortitude and self-management skills. The training was well received by mentors. Their self-efficacy increased significantly after training completion. Participants' experience of peer support was informed by the unique relationship with their peer. All participants were unequivocal about the need for

Peer-to-peer mentoring for individuals with early inflammatory arthritis: feasibility pilot

Science.gov (United States)

Sandhu, Sharron; Veinot, Paula; Embuldeniya, Gayathri; Brooks, Sydney; Sale, Joanna; Huang, Sicong; Zhao, Alex; Richards, Dawn; Bell, Mary J

2013-01-01

Objectives To examine the feasibility and potential benefits of early peer support to improve the health and quality of life of individuals with early inflammatory arthritis (EIA). Design Feasibility study using the 2008 Medical Research Council framework as a theoretical basis. A literature review, environmental scan, and interviews with patients, families and healthcare providers guided the development of peer mentor training sessions and a peer-to-peer mentoring programme. Peer mentors were trained and paired with a mentee to receive (face-to-face or telephone) support over 12 weeks. Setting Two academic teaching hospitals in Toronto, Ontario, Canada. Participants Nine pairs consisting of one peer mentor and one mentee were matched based on factors such as age and work status. Primary outcome measure Mentee outcomes of disease modifying antirheumatic drugs (DMARDs)/biological treatment use, self-efficacy, self-management, health-related quality of life, anxiety, coping efficacy, social support and disease activity were measured using validated tools. Descriptive statistics and effect sizes were calculated to determine clinically important (>0.3) changes. Peer mentor self-efficacy was assessed using a self-efficacy scale. Interviews conducted with participants examined acceptability and feasibility of procedures and outcome measures, as well as perspectives on the value of peer support for individuals with EIA. Themes were identified through constant comparison. Results Mentees experienced improvements in the overall arthritis impact on life, coping efficacy and social support (effect size >0.3). Mentees also perceived emotional, informational, appraisal and instrumental support. Mentors also reported benefits and learnt from mentees’ fortitude and self-management skills. The training was well received by mentors. Their self-efficacy increased significantly after training completion. Participants’ experience of peer support was informed by the unique

Computer-Based Methods for Collecting Peer Nomination Data: Utility, Practice, and Empirical Support.

Science.gov (United States)

van den Berg, Yvonne H M; Gommans, Rob

2017-09-01

New technologies have led to several major advances in psychological research over the past few decades. Peer nomination research is no exception. Thanks to these technological innovations, computerized data collection is becoming more common in peer nomination research. However, computer-based assessment is more than simply programming the questionnaire and asking respondents to fill it in on computers. In this chapter the advantages and challenges of computer-based assessments are discussed. In addition, a list of practical recommendations and considerations is provided to inform researchers on how computer-based methods can be applied to their own research. Although the focus is on the collection of peer nomination data in particular, many of the requirements, considerations, and implications are also relevant for those who consider the use of other sociometric assessment methods (e.g., paired comparisons, peer ratings, peer rankings) or computer-based assessments in general. © 2017 Wiley Periodicals, Inc.

The Impact of Quality Assurance Initiatives and Workplace Policies and Procedures on HIV/AIDS-Related Stigma Experienced by Patients and Nurses in Regions with High Prevalence of HIV/AIDS.

Science.gov (United States)

Hewko, Sarah J; Cummings, Greta G; Pietrosanu, Matthew; Edwards, Nancy

2018-02-23

Stigma is commonly experienced by people living with HIV/AIDS and by those providing care to HIV/AIDS patients. Few intervention studies have explored the impact of workplace policies and/or quality improvement on stigma. We examine the contribution of health care workplace policies, procedures and quality assurance initiatives, and self- and peer-assessed individual nurse practices, to nurse-reported HIV/AIDS-stigma practices toward patients living with HIV/AIDS and nurses in health care settings. Our sample of survey respondents (n = 1157) included managers (n = 392) and registered/enrolled nurses (n = 765) from 29 facilities in 4 countries (South Africa, Uganda, Jamaica, Kenya). This is one of the first studies in LMIC countries to use hierarchical linear modeling to examine the contributions of organizational and individual factors to HIV/AIDS stigma. Based on our results, we argue that organizational interventions explicitly targeting HIV/AIDS stigma are required to reduce the incidence, prevalence and morbidity of HIV/AIDS.

Potential Benefits of Incorporating Peer-to-Peer Interactions Into Digital Interventions for Psychotic Disorders: A Systematic Review.

Science.gov (United States)

Biagianti, Bruno; Quraishi, Sophia H; Schlosser, Danielle A

2018-04-01

Peer-to-peer interactions and support groups mitigate experiences of social isolation and loneliness often reported by individuals with psychotic disorders. Online peer-to-peer communication can promote broader use of this form of social support. Peer-to-peer interactions occur naturally on social media platforms, but they can negatively affect mental health. Recent digital interventions for persons with psychotic disorders have harnessed the principles of social media to incorporate peer-to-peer communication. This review examined the feasibility, acceptability, and preliminary efficacy of recent digital interventions in order to identify strategies to maximize benefits of online peer-to-peer communication for persons with psychotic disorders. An electronic database search of PubMed, EMBASE, PsycINFO, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Health Technology Assessment Database was conducted in February 2017 and yielded a total of 1,015 results. Eight publications that reported data from six independent trials and five interventions were reviewed. The technology supporting peer-to-peer communication varied greatly across studies, from online forums to embedded social networking. When peer-to-peer interactions were moderated by facilitators, retention, engagement, acceptability, and efficacy were higher than for interventions with no facilitators. Individuals with psychotic disorders were actively engaged with moderated peer-to-peer communication and showed improvements in perceived social support. Studies involving service users in intervention design showed higher rates of acceptability. Individuals with psychotic disorders value and benefit from digital interventions that include moderated peer-to-peer interactions. Incorporating peer-to-peer communication into digital interventions for this population may increase compliance with other evidence-based therapies by producing more acceptable and engaging online environments.

Confronting the HIV epidemic in Asia and the Pacific: developing successful strategies to minimize the spread of HIV infection.

Science.gov (United States)

Moodie, R; Aboagye-Kwarteng, T

1993-12-01

In Asia, the cumulative total of HIV-infected adults will reach 1.22 million by 1995, and, by 2000, the number is estimated to reach 11-45 million. The modes of transmission vary from country to country and include injecting drug users, commercial sex workers and their clients, commercial blood donors, hemophiliacs, and homosexuals. Social, cultural, and health factors also affect transmission, such as rites of passage to adulthood, lack of female autonomy, multiple sex partners, wars and civil unrest, and availability of drugs. The HIV epidemic has economic ramifications and causes, e.g., migrant worker camps, the sex industry, and rapid urbanization luring Burmese girls to Thailand. Governments must create an environment for behavior-change through financial, political, and legislative measures. Community organizations also play a role in prevention, as in programs initiated by a squatter settlement in Bangkok, where 36% of IV drug users were found to be HIV-positive. In Maharashtra State, India, peer-based prevention programs were developed for sex workers. Successful behavior change of individuals is based on redefinition of peer norms, understanding the danger and vulnerability to infection, and building confidence to change behavior. Successful programs require placing priority on HIV issues on the political agenda, negotiation and consensus-building skills, and competent program management. For instance, in Zimbabwe a project enlisted 380,000 people in 4500 education sessions within 2 years, and distributed 2.5 million condoms. Among sex workers, condom use increased from 5% to 50%. Implementation strategies include the provision of information and interpersonal education. In Zaire, mass media and social marketing efforts boosted condom sales from less than half a million in 1987 to over 20 million in 1991. The means to change behavior requires the availability of good quality condoms, disinfectants, and syringes. Furthermore, clinical management of

Correlates of HIV infection among street-based and venue-based sex workers in Vietnam.

Science.gov (United States)

Le, Thuy Tc; Nguyen, Quoc C; Tran, Ha Tt; Schwandt, Michael; Lim, Hyun J

2016-10-01

Commercial sex work is one of the driving forces of the HIV epidemic across the world. In Vietnam, although female sex workers (FSWs) carry a disproportionate burden of HIV, little is known about the risk profile and associated factors for HIV infection among this population. There is a need for large-scale research to obtain reliable and representative estimates of the measures of association. This study involved secondary data analysis of the 'HIV/STI Integrated Biological and Behavioral Surveillance' study in Vietnam in 2009-2010 to examine the correlates of HIV among FSWs. Data collected from 5298 FSWs, including 2530 street-based sex workers and 2768 venue-based sex workers from 10 provinces in Vietnam, were analyzed using descriptive statistics and bivariate and multivariate logistic regression analyses. HIV prevalence among the overall FSW population was 8.6% (n = 453). However, when stratified by FSW subpopulations, HIV prevalence was 10.6% (n = 267) for street-based sex workers and 6.7% (n = 186) for venue-based sex workers. Factors independently associated with HIV infection in the multivariate analysis, regardless of sex work types, were injecting drug use, high self-perceived HIV risk, and age ≥ 25 years. Additional factors independently associated with HIV risk within each FSW subpopulation included having ever been married among street-based sex workers and inconsistent condom use with clients and having sex partners who injected drugs among venue-based sex workers. Apart from strategies addressing modifiable risk behaviours among all FSWs, targeted strategies to address specific risk behaviours within each FSW subpopulation should be adopted. © The Author(s) 2016.

Peer support and peer-led family support for persons living with schizophrenia.

Science.gov (United States)

Duckworth, Kenneth; Halpern, Lisa

2014-05-01

Peer support and peer-led family psychoeducation represent two distinct and complementary recovery-oriented models to support individuals who live with schizophrenia and their families, respectively. The goals of these models focus on improving knowledge, coping, self-care, social support, and self-management strategies. These models represent important capacity-building strategies for people who live with the illness and the people who love them. This brief article is intended to provide the practicing clinician, person living with schizophrenia, and policy maker with a working knowledge of the current state of the literature in these two related fields. Practitioners should consider these resources and integrate them into their care. A person living with schizophrenia could use this review to advocate for appropriate resources and to identify career opportunities. Policy makers could benefit from an understanding of the literature to mitigate financial and cultural barriers to adopting these practices. The last 5 years have seen a dramatic expansion of the application of randomized controlled trials (RCTs) to give evidence to match the experience of people in these programs. The field has seen Wellness Recovery Action Plan (WRAP) named as evidence-based practice by the National Registry of Evidence-Based Practices. A RCT was also conducted for another peer-developed and led program called Building Recovery of Individual Dreams & Goals through Education & Support. Family to Family, the largest peer-led family psychoeducation course, was also found to have significant impact after the study and also 6 months later in RCT. Family to Family has also been named as an evidence-based practice. The field of people who are living well with schizophrenia working as resources and supports to others living with the illness is an idea that is growing momentum. This momentum has been matched by the RCT evidence. Peer support as a professional role has an emerging literature

Using Web-Based Peer Benchmarking to Manage the Client-Based Project

Science.gov (United States)

Raska, David; Keller, Eileen Weisenbach; Shaw, Doris

2013-01-01

The complexities of integrating client-based projects into marketing courses provide challenges for the instructor but produce richness of context and active learning for the student. This paper explains the integration of Web-based peer benchmarking as a means of improving student performance on client-based projects within a single semester in…

The Effect of Menstrual Health Education Conducted with Peer Education Method to Adolescent Girls in 6-8 Classes on Information and Behaviors

Directory of Open Access Journals (Sweden)

Zehra Golbasi

2012-04-01

Full Text Available Aim: Research was conducted as a experimental study in order to determine the effect of menstrual health education conducted with peer education to adolescent girls in 6-8 classes on information and behaviors. Method: The study was made in Primary School of Regional Girl Boarding. Working group consisted of 202 students responded completely pre-test and post-test from 214 female students studying in this school in 2008-2009 academic year. Data were collected by Personal Information Form, Menstruation and Menstrual Health Information Form. The forms were implemented to all students before the start of peer education program. Then, a total of 24 students including two students from each class were chosen as a peer educator with simple random sampling method. Peer educators were given information about menstruation and menstrual health for 2 hours per week and a total of 6 hours during 3 weeks in line with the educational booklet. Peer educator were asked to share acquired this information with classmates in various environments. Forms used at the beginning of students were applied to students again 4 weeks after completion of peer education program. Results: The average score of the students' knowledge of menstruation and menstrual health increased significantly (p <0.05 after the peer education program. Also, a statistically significant increase has occurred in the behaviors of students’ washing their hands before the toilet during menstruation, lustrating from front to back with toilet paper, bathing in the form of shower during menstruation, using cotton underwear, changing frequently pads used and taking away the pads used by wrapping (p<0.05. Conclusion: It can be considered that the method of peer education is an effective method to increase knowledge of adolescent girls about menstruation and menstrual health and develop health behaviors. [TAF Prev Med Bull 2012; 11(2.000: 191-198

Depressive and conduct disorder symptoms in youth living with HIV: the independent and interactive roles of coping and neuropsychological functioning.

Science.gov (United States)

Salama, Christina; Morris, Mary; Armistead, Lisa; Koenig, Linda J; Demas, Penelope; Ferdon, Corinne; Bachanas, Pamela

2013-01-01

Emerging research suggests the importance of psychosocial characteristics (e.g., coping and social support) for positive adaptation among youth with behaviorally acquired HIV. However, little is known about how these traits interact with cognitive abilities to impact emotional and behavioral adjustment. This study examined whether coping skills and executive functioning interact in their association with psychological adjustment in HIV-positive youth. Data from Project Adolescents Living with HIV/AIDS (ALPHA), a study to examine psychosocial, behavioral and neuropsychological functioning of youth with behaviorally acquired HIV, were used. Fifty-nine participants, aged 14-23, diagnosed with HIV prior to age 20 and receiving care in one of two HIV clinics in Atlanta or New York City, were recruited, consented and enrolled. Participants completed measures of depressive symptoms (Beck Depression Inventory), conduct disorder (Adolescent Symptom Index), and use of positive and negative coping strategies (Kidcope). The Wisconsin Card Sorting Test (WCST) assessed abstract reasoning (categories completed) and cognitive inflexibility (perseverative errors). In this sample of HIV-positive youth, depressive symptoms were best predicted by an interactive combination of negative coping skills and poor neuropsychological functioning. Neuropsychological functioning (cognitive inflexibility) and negative coping skills were directly associated with conduct disorder symptoms. Results highlight the importance of including neuropsychological assessment in the evaluation of HIV-positive youth, particularly those with emotional or behavioral problems.

Strengthening School-Based Occupational Therapy through Peer Mentoring

Science.gov (United States)

Bucey, Janet C.; Provident, Ingrid M.

2018-01-01

This article evaluates a peer mentoring experience for school-based practitioners and its effect on collaborative consultation practices. Best practice and public school policy promote the use of collaborative consultation services but school-based practitioners report significant barriers in achieving effective collaborative consultation…

Risk behaviors and reasons for not getting tested for HIV among men who have sex with men: an online survey in Peru.

Directory of Open Access Journals (Sweden)

Magaly M Blas

Full Text Available Men who have sex with men (MSM account for the greatest burden of the HIV epidemic in Peru. Given that MSM are frequent users of the Internet, understanding the risk behaviors and the reasons for not getting tested among MSM who surf the Internet may improve the tailoring of future online behavioral interventions.From October 2007 to April 2008, we conducted an online survey among users of seven Peruvian gay websites.We received 1,481 surveys, 1,301 of which were included in the analysis. The median age of the participants was 22.5 years (range 12-71, 67% were homosexual, and the remainder was bisexual. Of survey respondents, 49.4% had never been tested for HIV and only 11.3% were contacted in-person during the last year by peer health educators from the Peruvian Ministry of Health and NGOs. Additionally, 50.8% had unprotected anal or vaginal sex at last intercourse, and a significant percentage reported a condom broken (22.1%, slipped (16.4% or sexual intercourse initiated without wearing a condom (39.1%. The most common reasons for not getting tested for HIV among high-risk MSM were "I fear the consequences of a positive test result" (n = 55, 34.4%, and "I don't know where I can get tested" (n = 50, 31.3%.A small percentage of Peruvian MSM who answered our online survey, were reached by traditional peer-based education programs. Given that among high-risk MSM, fear of a positive test result and lack of awareness of places where to get tested are the most important reasons for not taking an HIV test, Internet interventions aimed at motivating HIV testing should work to reduce fear of testing and increase awareness of places that offer free HIV testing services to MSM.

Gender and HIV/AIDS in Bangladesh: A review

Directory of Open Access Journals (Sweden)

Joydeb Garai

2016-11-01

Full Text Available Introduction: The HIV/AIDS epidemic portrays a growing health threat in the world. In Bangladesh, the prevalence rate of HIV/AIDS is not yet high but it is gradually becoming a threat especially for women and young girls due to gender disparity. This systematic review was conducted to explore the gender-specific vulnerability to HIV/AIDS in Bangladesh in order to suggest to policy makers the best way for the prevention of HIV/AIDS in Bangladesh as well as in other low income countries. Methods: Peer review articles were identified using a systematic search of two databases: Pubmed and Goggle Scholar. The search was limited to studies published in English between 1998 and 2016 and included a special focus on articles addressing the gender-specific risk factors to HIV/ AIDS. Discussion and Conclusion: This paper analyzes how women and girls in marginalized position in the society fall victim to HIV/AIDS due to gender disparities and other related issues. The findings of the study indicate that women and young girls are the most vulnerable to HIV/AIDS infection among the general people. Along with biological susceptibility, other major causes of this vulnerability of women and girls are gender inequality, sexual abuse and violence, social stigma, inability to decision making power, economic dependency and men’s sexual power and privilege over women. This paper helps policy makers and invites them to take special care to reduce gender inequality before implementing any policy for the prevention of HIV/AIDS in Bangladesh as well as in low income countries.

HIV prevention and education in state prison systems: an update.

Science.gov (United States)

Lyons, Thomas; Osunkoya, Emmanuel; Anguh, Ivonne; Adefuye, Adedeji; Balogun, Joseph

2014-04-01

The prevalence rate of HIV infection in jails and prisons is approximately 5 times the rate in the U.S. general population. The authors surveyed state prison officials to assess HIV testing and HIV prevention policies--specifically voluntary testing, group HIV prevention counseling, and peer education--in the 50 states and to determine whether those policies are associated with the characteristics of the state and its prison population.

PrEP Chicago: A randomized controlled peer change agent intervention to promote the adoption of pre-exposure prophylaxis for HIV prevention among young Black men who have sex with men.

Science.gov (United States)

Young, Lindsay E; Schumm, Phil; Alon, Leigh; Bouris, Alida; Ferreira, Matthew; Hill, Brandon; Khanna, Aditya S; Valente, Thomas W; Schneider, John A

2018-02-01

Advances in biomedical prevention strategies such as pre-exposure prophylaxis (PrEP) represent a new opportunity for reducing HIV incidence among young Black men who have sex with men, for whom the number of new HIV infections continues to rise. However, studies have documented low rates of PrEP uptake in this community. Research suggests that the peer networks of young Black men who have sex with men play important roles in their sexual health decisions. PrEP Chicago is a randomized controlled trial network intervention designed to increase PrEP uptake among young Black men who have sex with men living in Chicago. The aims of this study are twofold. Aim 1 is to estimate the effectiveness of a peer change agent intervention for (1) increasing the number of referrals made to a PrEP information line, (2) increasing the rate of PrEP adoption among non-participant peers, and (3) increasing PrEP knowledge, attitudes, and intentions among participants. Aim 2 is to determine the individual and network variables that explain peer change agent effectiveness. PrEP Chicago is a social network intervention that utilizes the influence of peer change agents to link young Black men who have sex with men in Chicago to PrEP. Young Black men who have sex with men were recruited using respondent-driven sampling. Once screened for eligibility, participants were randomly assigned to either one of two treatment sequences: (1) intervention treatment in Year 1 followed by a minimal contact attention control in Year 2 or (2) the minimal contact attention control in Year 1 followed by treatment in Year 2. The treatment consists of a PrEP/peer change agent training workshop followed by booster calls for 12 months. The attention control consists of a sex diary activity designed to help participants assess sexual risk. Psychosocial, sexual health, and network data are collected from all participants at baseline and at 12- and 24-month follow-ups. In total, 423 participants aged 18-35 have

Reliability assessment of a peer evaluation instrument in a team-based learning course

Directory of Open Access Journals (Sweden)

Wahawisan J

2016-03-01

Full Text Available Objective: To evaluate the reliability of a peer evaluation instrument in a longitudinal team-based learning setting. Methods: Student pharmacists were instructed to evaluate the contributions of their peers. Evaluations were analyzed for the variance of the scores by identifying low, medium, and high scores. Agreement between performance ratings within each group of students was assessed via intra-class correlation coefficient (ICC. Results: We found little variation in the standard deviation (SD based on the score means among the high, medium, and low scores within each group. The lack of variation in SD of results between groups suggests that the peer evaluation instrument produces precise results. The ICC showed strong concordance among raters. Conclusions: Findings suggest that our student peer evaluation instrument provides a reliable method for peer assessment in team-based learning settings.

The effects of online peer feedback and epistemic beliefs on students’ argumentation-based learning

OpenAIRE

Noroozi, Omid; Hatami, Javad

2018-01-01

Although the importance of students’ argumentative peer feedback for learning is undeniable, there is a need for further empirical evidence on whether and how it is related to various aspects of argumentation-based learning namely argumentative essay writing, domain-specific learning, and attitudinal change while considering their epistemic beliefs which are known to be related to argumentation. In this study, a pre-test–post-test design was conducted with 42 higher education students who wer...

Peer victimization and peer rejection during early childhood

Science.gov (United States)

Godleski, Stephanie A.; Kamper, Kimberly E.; Ostrov, Jamie M.; Hart, Emily J.; Blakely-McClure, Sarah J.

2014-01-01

Objective The development and course of the subtypes of peer victimization is a relatively understudied topic despite the association of victimization with important developmental and clinical outcomes. Moreover, understanding potential predictors, such as peer rejection and emotion regulation, in early childhood may be especially important to elucidate possible bi-directional pathways between relational and physical victimization and rejection. The current study (N = 97) was designed to explore several gaps and limitations in the peer victimization and peer rejection literature. In particular, the prospective associations between relational and physical victimization and peer rejection over the course of 3.5 months during early childhood (i.e., 3- to 5- years-old) were investigated in an integrated model. Method The study consisted of 97 (42 girls) preschool children recruited from four early childhood schools in the northeast of the US. Using observations, research assistant report and teacher report, relational and physical aggression, relational and physical victimization, peer rejection, and emotion regulation were measured in a short-term longitudinal study. Path analyses were conducted to test the overall hypothesized model. Results Peer rejection was found to predict increases in relational victimization. In addition, emotion regulation was found to predict decreases in peer rejection and physical victimization. Conclusions Implications for research and practice are discussed, including teaching coping strategies for peer rejection and emotional distress. PMID:25133659

Evaluating the effect of HIV prevention strategies on uptake of HIV counselling and testing among male most-at-risk-populations in Nigeria; a cross-sectional analysis.

Science.gov (United States)

Adebajo, Sylvia; Eluwa, George; Njab, Jean; Oginni, Ayo; Ukwuije, Francis; Ahonsi, Babatunde; Lorenc, Theo

2015-12-01

The aim of this study was to evaluate the effects of three strategies in increasing uptake of HIV counselling and testing (HCT) among male most-at-risk-population (M-MARPs) using programmatic data. HIV prevention strategies were evaluated in a cross-sectional analysis. Three HCT strategies were implemented between July 2009 and July 2012 among men who have sex with men (MSM) and people who inject drugs (PWIDs) in four states in Nigeria. The first strategy (S1), involved key opinion leaders (KOLs) who referred M-MARPs to health facilities for HCT. The second strategy (S2) involved KOLs referring M-MARPs to nearby mobile HCT teams while the third (S3) involved mobile M-MARPs peers conducting the HCT. χ(2) statistics were used to test for differences in the distribution of categorical variables across groups while logistic regression was used to measure the effect of the different strategies while controlling for confounding factors. A total of 1988, 14 726 and 14 895 M-MARPs were offered HCT through S1, S2 and S3 strategies, respectively. Overall, S3 (13%) identified the highest proportion of HIV-positive M-MARPs compared with S1 (9%) and S2 (3%), p≤0.001. Also S3 (13%) identified the highest proportion of new HIV diagnosis compared with S1 (8%) and S2 (3%), respectively, p≤0.001. When controlled for age, marital status and occupation, MSM reached via S3 were 9 times (AOR: 9.21; 95% CI 5.57 to 15.23) more likely to uptake HCT when compared with S1 while PWIDs were 21 times (AOR: 20.90; 95% CI 17.33 to 25.21) more likely to uptake to HCT compared with those reached via S1. Peer-led HCT delivered by S3 had the highest impact on the total number of M-MARPs reached and in identifying HIV-positive M-MARPs and new testers. Training M-MARPs peers to provide HCT is a high impact approach in delivering HCT to M-MARPs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Mental Health of HIV-Seropositive Women During Pregnancy and Postpartum Period: A Comprehensive Literature Review

Science.gov (United States)

Dass-Brailsford, Priscilla; Nora, Diana; Talisman, Nicholas

2014-01-01

With growing numbers of HIV-seropositive (HIV+) women of child-bearing age and increased access to effective clinical protocols for preventing mother-to-child transmission (MTCT) of HIV, mental health-related factors have become increasingly relevant due to their potential to affect the women’s quality of life, obstetric outcomes and risk of MTCT. This review synthesizes evidence from 53 peer-reviewed publications examining mental health-related variables in pregnant and postpartum HIV+ women. The presentation of results is organized by the level of socioeconomic resources in the countries where studies were conducted (i.e., high-, middle-, and low-income countries). It is concluded that psychiatric symptoms, particularly depression, and mental health vulnerabilities (e.g., inadequate coping skills) are widespread among pregnant HIV+ women globally and have a potential to affect psychological well-being, quality of life and salient clinical outcomes. The current body of evidence provides rationale for developing and evaluating clinical and structural interventions aimed at improving mental health outcomes and their clinical correlates in pregnant HIV+ women. PMID:24584458

Promoting Residential Renewable Energy via Peer-to-Peer Learning

Science.gov (United States)

Heiskanen, Eva; Nissilä, Heli; Tainio, Pasi

2017-01-01

Peer-to-peer learning is gaining increasing attention in nonformal community-based environmental education. This article evaluates a novel modification of a concept for peer-to-peer learning about residential energy solutions (Open Homes). We organized collective "Energy Walks" visiting several homes with novel energy solutions and…

Experimental evaluation of ontology-based HIV/AIDS frequently asked question retrieval system.

Science.gov (United States)

Ayalew, Yirsaw; Moeng, Barbara; Mosweunyane, Gontlafetse

2018-05-01

This study presents the results of experimental evaluations of an ontology-based frequently asked question retrieval system in the domain of HIV and AIDS. The main purpose of the system is to provide answers to questions on HIV/AIDS using ontology. To evaluate the effectiveness of the frequently asked question retrieval system, we conducted two experiments. The first experiment focused on the evaluation of the quality of the ontology we developed using the OQuaRE evaluation framework which is based on software quality metrics and metrics designed for ontology quality evaluation. The second experiment focused on evaluating the effectiveness of the ontology in retrieving relevant answers. For this we used an open-source information retrieval platform, Terrier, with retrieval models BM25 and PL2. For the measurement of performance, we used the measures mean average precision, mean reciprocal rank, and precision at 5. The results suggest that frequently asked question retrieval with ontology is more effective than frequently asked question retrieval without ontology in the domain of HIV/AIDS.

Aligning faith-based and national HIV/AIDS prevention responses? Factors influencing the HIV/AIDS prevention policy process and response of faith-based NGOs in Tanzania.

Science.gov (United States)

Morgan, Rosemary; Green, Andrew; Boesten, Jelke

2014-05-01

Faith-based organizations (FBOs) have a long tradition of providing HIV/AIDS prevention and mitigation services in Africa. The overall response of FBOs, however, has been controversial, particularly in regard to HIV/AIDS prevention and FBO's rejection of condom use and promotion, which can conflict with and negatively influence national HIV/AIDS prevention response efforts. This article reports the findings from a study that explored the factors influencing the HIV/AIDS prevention policy process within faith-based non-governmental organizations (NGOs) of different faiths. These factors were examined within three faith-based NGOs in Dar es Salaam, Tanzania-a Catholic, Anglican and Muslim organization. The research used an exploratory, qualitative case-study approach, and employed a health policy analysis framework, examining the context, actor and process factors and how they interact to form content in terms of policy and its implementation within each organization. Three key factors were found to influence faith-based NGOs' HIV/AIDS prevention response in terms of both policy and its implementation: (1) the faith structure in which the organizations are a part, (2) the presence or absence of organizational policy and (3) the professional nature of the organizations and its actors. The interaction between these factors, and how actors negotiate between them, was found to shape the organizations' HIV/AIDS prevention response. This article reports on these factors and analyses the different HIV/AIDS prevention responses found within each organization. By understanding the factors that influence faith-based NGOs' HIV/AIDS prevention policy process, the overall faith-based response to HIV/AIDS, and how it corresponds to national response efforts, is better understood. It is hoped that by doing so the government will be better able to identify how to best work with FBOs to meet national HIV/AIDS prevention targets, improving the overall role of FBOs in the fight against

HIV testing and tolerance to gender based violence: a cross-sectional study in Zambia.

Directory of Open Access Journals (Sweden)

Sara Gari

Full Text Available This paper explores the effect of social relations and gender-based conflicts on the uptake of HIV testing in the South and Central provinces of Zambia. We conducted a community-based cross-sectional study of 1716 randomly selected individuals. Associations were examined using mixed-effect multivariable logistic regression. A total of 264 men (64% and 268 women (56% had never tested for HIV. The strongest determinants for not being tested were disruptive couple relationships (OR = 2.48 95% CI = 1.00-6.19; tolerance to gender-based violence (OR = 2.10 95% CI = 1.05-4.32 and fear of social rejection (OR = 1.48 95% CI = 1.23-1.80. In the Zambian context, unequal power relationships within the couple and the community seem to play a pivotal role in the decision to test which until now have been largely underestimated. Policies, programs and interventions to rapidly increase HIV testing need to urgently address gender-power inequity in relationships and prevent gender-based violence to reduce the negative impact on the lives of couples and families.

Ethical Issues in Using Social Media to Deliver an HIV Prevention Intervention: Results from the HOPE Peru Study.

Science.gov (United States)

Garett, Renee; Menacho, Luis; Young, Sean D

2017-02-01

Social media technologies have become increasingly useful tools for research-based interventions. However, participants and social media users have expressed ethical concerns with these studies, such as risks and benefits of participation, as well as privacy, confidentiality, and informed consent issues. This study was designed to follow up with and assess experiences and perceptions of ethics-related issues among a sample of 211 men who have sex with men who participated in the Harnessing Online Peer Education (HOPE) Peru study, a randomized controlled HIV prevention intervention conducted in Peru. We found that after adjusting for age, highest educational attainment, race, sexual orientation, and prior HIV research experience, participants in the intervention group were more likely than those in the control group to have safe sex (p = 0.0051) and get tested for HIV regularly (p = 0.0051). As a result of their participation, those in the intervention group benefited more positively than participants in the control group in improving HIV care (p = 0.0077) and learning where to receive sexual health services (p = 0.0021). Participants in the intervention group expressed higher levels of comfort than those in the control group in joining and seeing other people in the Facebook group (p = 0.039), seeing other people's posts (p = 0.038) and having other group members talk to them online (p = 0.040). We discuss the implications of these results as they relate to social media-based HIV research.

Ethical issues in using social media to deliver an HIV prevention intervention: Results from the HOPE Peru Study

Science.gov (United States)

Garett, Renee; Menacho, Luis; Young, Sean D.

2017-01-01

Social media technologies have become increasingly useful tools for research-based interventions. However, participants and social media users have expressed ethical concerns with these studies, such as risks and benefits of participation, as well as privacy, confidentiality, and informed consent issues. This study was designed to follow up with and assess experiences and perceptions of ethics-related issues among a sample of 211 men who have sex with men who participated in the Harnessing Online Peer Education (HOPE) Peru study, a randomized controlled HIV prevention intervention conducted in Peru. We found that after adjusting for age, highest educational attainment, race, sexual orientation, and prior HIV research experience, participants in the intervention group were more likely than those in the control group to have safe sex (p = 0.0051) and get tested for HIV regularly (p = 0.0051). As a result of their participation, those in the intervention group benefited more positively than participants in the control group in improving HIV care (p = 0.0077) and learning where to receive sexual health services (p = 0.0021). Participants in the intervention group expressed higher levels of comfort than those in the control group in joining and seeing other people in the Facebook group (p = 0.039), seeing other people’s posts (p = 0.038), and having other group members talk to them online (p = 0.040). We discuss the implications of these results as they relate to social media–based HIV research. PMID:27933425

Working Memory Profiles in HIV-Exposed, Uninfected and HIV-Infected Children: A Comparison with Neurotypical Controls

Science.gov (United States)

Milligan, Robyn; Cockcroft, Kate

2017-01-01

This study compared the working memory profiles of three groups of children, namely HIV-infected (HIV-I; n = 95), HIV-exposed, uninfected (HIV-EU; n = 86) and an HIV-unexposed, uninfected, (HIV-UU; n = 92) neurotypical control group. Working memory, an executive function, plays an important role in frontal lobe-controlled behaviors, such as motivation, planning, decision making, and social interaction, and is a strong predictor of academic success in school children. Memory impairments have been identified in HIV-I children, particularly in visuospatial processing. Verbal working memory has not been commonly investigated in this population, while it is unknown how the working memory profiles of HIV-EU children compare to their HIV-I and HIV-UU peers. Of interest was whether the working memory profiles of the HIV-EU children would be more similar to the HIV-I group or to the uninfected control group. The results revealed no significant differences in working memory performance between the HIV-I and HIV-EU groups. However, this does not mean that the etiology of the working memory deficits is the same in the two groups, as these groups showed important differences when compared to the control group. In comparison to the controls, the HIV-I group experienced difficulties with processing tasks irrespective of whether they drew on a verbal or visuospatial modality. This appears to stem from a generalized executive function deficit that also interferes with working memory. In the HIV-EU group, difficulties occurred with verbally based tasks, irrespective of whether they required storage or processing. For this group, the dual demands of complex processing and using a second language seem to result in demand exceeding capacity on verbal tasks. Both groups experienced the greatest difficulties with verbal processing tasks for these different reasons. Thus, disruption of different cognitive abilities could result in similar working memory profiles, as evidenced in this

Working Memory Profiles in HIV-Exposed, Uninfected and HIV-Infected Children: A Comparison with Neurotypical Controls.

Science.gov (United States)

Milligan, Robyn; Cockcroft, Kate

2017-01-01

This study compared the working memory profiles of three groups of children, namely HIV-infected (HIV-I; n = 95), HIV-exposed, uninfected (HIV-EU; n = 86) and an HIV-unexposed, uninfected, (HIV-UU; n = 92) neurotypical control group. Working memory, an executive function, plays an important role in frontal lobe-controlled behaviors, such as motivation, planning, decision making, and social interaction, and is a strong predictor of academic success in school children. Memory impairments have been identified in HIV-I children, particularly in visuospatial processing. Verbal working memory has not been commonly investigated in this population, while it is unknown how the working memory profiles of HIV-EU children compare to their HIV-I and HIV-UU peers. Of interest was whether the working memory profiles of the HIV-EU children would be more similar to the HIV-I group or to the uninfected control group. The results revealed no significant differences in working memory performance between the HIV-I and HIV-EU groups. However, this does not mean that the etiology of the working memory deficits is the same in the two groups, as these groups showed important differences when compared to the control group. In comparison to the controls, the HIV-I group experienced difficulties with processing tasks irrespective of whether they drew on a verbal or visuospatial modality. This appears to stem from a generalized executive function deficit that also interferes with working memory. In the HIV-EU group, difficulties occurred with verbally based tasks, irrespective of whether they required storage or processing. For this group, the dual demands of complex processing and using a second language seem to result in demand exceeding capacity on verbal tasks. Both groups experienced the greatest difficulties with verbal processing tasks for these different reasons. Thus, disruption of different cognitive abilities could result in similar working memory profiles, as evidenced in this

Working Memory Profiles in HIV-Exposed, Uninfected and HIV-Infected Children: A Comparison with Neurotypical Controls

Directory of Open Access Journals (Sweden)

Robyn Milligan

2017-07-01

Full Text Available This study compared the working memory profiles of three groups of children, namely HIV-infected (HIV-I; n = 95, HIV-exposed, uninfected (HIV-EU; n = 86 and an HIV-unexposed, uninfected, (HIV-UU; n = 92 neurotypical control group. Working memory, an executive function, plays an important role in frontal lobe-controlled behaviors, such as motivation, planning, decision making, and social interaction, and is a strong predictor of academic success in school children. Memory impairments have been identified in HIV-I children, particularly in visuospatial processing. Verbal working memory has not been commonly investigated in this population, while it is unknown how the working memory profiles of HIV-EU children compare to their HIV-I and HIV-UU peers. Of interest was whether the working memory profiles of the HIV-EU children would be more similar to the HIV-I group or to the uninfected control group. The results revealed no significant differences in working memory performance between the HIV-I and HIV-EU groups. However, this does not mean that the etiology of the working memory deficits is the same in the two groups, as these groups showed important differences when compared to the control group. In comparison to the controls, the HIV-I group experienced difficulties with processing tasks irrespective of whether they drew on a verbal or visuospatial modality. This appears to stem from a generalized executive function deficit that also interferes with working memory. In the HIV-EU group, difficulties occurred with verbally based tasks, irrespective of whether they required storage or processing. For this group, the dual demands of complex processing and using a second language seem to result in demand exceeding capacity on verbal tasks. Both groups experienced the greatest difficulties with verbal processing tasks for these different reasons. Thus, disruption of different cognitive abilities could result in similar working memory profiles, as

Peer counselors' role in supporting patients' adherence to ART in Ethiopia and Uganda.

Science.gov (United States)

Gusdal, Annelie K; Obua, Celestino; Andualem, Tenaw; Wahlstrom, Rolf; Chalker, John; Fochsen, Grethe

2011-06-01

Our aim was to explore peer counselors' work and their role in supporting patients' adherence to antiretroviral treatment (ART) in resource-limited settings in Ethiopia and Uganda. Qualitative semi-structured interviews were conducted with 79 patients, 17 peer counselors, and 22 providers in ART facilities in urban and rural areas of Ethiopia and Uganda. Two main categories with related subcategories emerged from the analysis. The first main category, peer counselors as facilitators of adherence, describes how peer counselors played an important role by acting as role models, raising awareness, and being visible in the community. They were also recognized for being close to the patients while acting as a bridge to the health system. They provided patients with an opportunity to individually talk to someone who was also living with HIV, who had a positive and life-affirming attitude about their situation, and were willing to share personal stories of hope when educating and counseling their patients. The second main category, benefits and challenges of peer counseling, deals with how peer counselors found reward in helping others while at the same time acknowledging their limitations and need of support and remuneration. Their role and function were not clearly defined within the health system and they received negligible financial and organizational support. While peer counseling is acknowledged as an essential vehicle for treatment success in ART support in sub-Saharan Africa, a formal recognition and regulation of their role should be defined. The issue of strategies for disclosure to support adherence, while avoiding or reducing stigma, also requires specific attention. We argue that the development and implementation of support to peer counselors are crucial in existing and future ART programs, but more research is needed to further explore factors that are important to sustain and strengthen the work of peer counselors.

Peer mentoring works!

OpenAIRE

Andrews, Jane; Clark, Robin

2011-01-01

This report draws on the findings of a three year study into peer mentoring conducted at 6 Higher Education Institutions (HEIs), 5 of which were in the UK, 1 of which was in Norway. Following a multiple case-study design, quantitative and qualitative research was conducted in collaboration with the project partners. The research findings provide empirical evidence that peer mentoring works! In particular the report provides: - An Executive Summary outlining the main project findings - A synop...

Process assessment of a peer education programme for HIV prevention among sex workers in Dhaka, Bangladesh : a social support framework.

Science.gov (United States)

Sarafian, Isabelle

2012-08-01

This study evaluated the process of a peer education program for hotel-based sex workers in Dhaka, Bangladesh, with social support proposed as an organizing framework. Programme outcomes were examined through baseline and follow-up assessments. Sex workers naïve to peer education were assessed on socio-cognitive and behavioural variables; a subsample was reassessed at follow-up 23 weeks later on average. Process was assessed in terms of the content of peer education sessions. These sessions were recorded and coded into percentages of social support types provided by the peer educator to her audience: informational, instrumental, appraisal, emotional, companionship, non-support. Peer educators were classified into three "social support profiles" based on average proportions of emotional and informational support they provided. Seeing more peer educators with a high informational support profile was related to higher sex worker self-efficacy, self-reported STI symptoms, and self-reported condom use at follow-up; the same was true for the high emotional support profile and treatment seeking. Social support constituted a useful framework, but needs further exploration. This study provided a direct, in-depth examination of the process of peer education based on a comprehensive theoretical framework. Copyright © 2011 Elsevier Ltd. All rights reserved.

Peer-assisted learning: time for nomenclature clarification

Directory of Open Access Journals (Sweden)

Alexander Olaussen

2016-07-01

Full Text Available Background: Peer-assisted learning (PAL is used throughout all levels of healthcare education. Lack of formalised agreement on different PAL programmes may confuse the literature. Given the increasing interest in PAL as an education philosophy, the terms need clarification. The aim of this review is to 1 describe different PAL programmes, 2 clarify the terminology surrounding PAL, and 3 propose a simple pragmatic way of defining PAL programmes based on their design. Methods: A review of current PAL programmes within the healthcare setting was conducted. Each programme was scrutinised based on two aspects: the relationship between student and teacher, and the student to teacher ratio. The studies were then shown to fit exclusively into the novel proposed classification. Results: The 34 programmes found, demonstrate a wide variety in terms used. We established six terms, which exclusively applied to the programmes. The relationship between student and teacher was categorised as peer-to-peer or near-peer. The student to teacher ratio suited three groupings, named intuitively ‘Mentoring’ (1:1 or 1:2, ‘Tutoring’ (1:3–10, and ‘Didactic’ (1:>10. From this, six novel terms – all under the heading of PAL – are suggested: ‘Peer Mentoring’, ‘Peer Tutoring’, ‘Peer Didactic’, ‘Near-Peer Mentoring’, ‘Near-Peer Tutoring’, and ‘Near-Peer Didactic’. Conclusions: We suggest herein a simple pragmatic terminology to overcome ambiguous terminology. Academically, clear terms will allow effective and efficient research, ensuring furthering of the educational philosophy.

Peer-assisted learning: time for nomenclature clarification

Science.gov (United States)

Olaussen, Alexander; Reddy, Priya; Irvine, Susan; Williams, Brett

2016-01-01

Background Peer-assisted learning (PAL) is used throughout all levels of healthcare education. Lack of formalised agreement on different PAL programmes may confuse the literature. Given the increasing interest in PAL as an education philosophy, the terms need clarification. The aim of this review is to 1) describe different PAL programmes, 2) clarify the terminology surrounding PAL, and 3) propose a simple pragmatic way of defining PAL programmes based on their design. Methods A review of current PAL programmes within the healthcare setting was conducted. Each programme was scrutinised based on two aspects: the relationship between student and teacher, and the student to teacher ratio. The studies were then shown to fit exclusively into the novel proposed classification. Results The 34 programmes found, demonstrate a wide variety in terms used. We established six terms, which exclusively applied to the programmes. The relationship between student and teacher was categorised as peer-to-peer or near-peer. The student to teacher ratio suited three groupings, named intuitively ‘Mentoring’ (1:1 or 1:2), ‘Tutoring’ (1:3–10), and ‘Didactic’ (1:>10). From this, six novel terms – all under the heading of PAL – are suggested: ‘Peer Mentoring’, ‘Peer Tutoring’, ‘Peer Didactic’, ‘Near-Peer Mentoring’, ‘Near-Peer Tutoring’, and ‘Near-Peer Didactic’. Conclusions We suggest herein a simple pragmatic terminology to overcome ambiguous terminology. Academically, clear terms will allow effective and efficient research, ensuring furthering of the educational philosophy. PMID:27415590

Social-support needs among adolescents living with HIV in transition from pediatric to adult care in Cambodia: findings from a cross-sectional study.

Science.gov (United States)

Toth, Graham; Mburu, Gitau; Tuot, Sovannary; Khol, Vohith; Ngin, Chanrith; Chhoun, Pheak; Yi, Siyan

2018-03-28

Understanding the circumstances of adolescents living with HIV is critical in designing adolescent-friendly services that will facilitate successful transition from pediatric to adult care. This study describes access, utilization and ongoing social support needs among adolescents living with HIV aged 15-17 in transition from pediatric to adult HIV care in Cambodia. A cross-sectional study was conducted among 328 adolescents, randomly selected from 11 antiretroviral therapy (ART) clinics across the country. Descriptive analyses were conducted to summarize their characteristics, access to social support and ongoing support needs among male and female adolescents. Mean age of the study participants was 15.8 (SD = 0.8) years. Just over half (55.2%) were male. Most had at least one deceased parent (mother 50.9%; father 60.5%), and majority were living with biological parents (40.8%) or relatives (49.3%). A third came from families with an ID poor card, and 21.0% were working for pay. Almost half (46.6%) reported that their family had received social support for their health care, including food support (76.5%), school allowance (62.1%), transport allowance to ART clinics (53.6%), psychosocial counseling (35.3%), vocational training (22.9%) or home visits (11.1%). Several ongoing social support needs were identified, including ongoing inability to cover health expenses unless they are supported by health insurance or health equity fund (55.0%). In addition, adolescents reported having been asked to come back earlier than their scheduled appointment (13.7%), having had to purchase their own drugs (2.7%), experiencing HIV stigma (32.0%), having been denied housing or food due to HIV (8.2%) or failing to attend school within the past month partly because of HIV (16.8%). Two-thirds did not have access to peer support groups. Social protection mechanisms are reaching some adolescents in need, while other remain without social support due to discontinuities in health and

NCHRP peer exchange 2008.

Science.gov (United States)

2008-09-01

Peer exchanges for state department of transportation (DOT) research programs originated with : the Intermodal Surface Transportation Efficiency Act of 1991 (ISTEA). That federal legislation : required the states to conduct periodic peer exchanges to...

Mathematical Framework For Analyzing Incentives In Peer-To-Peer

African Journals Online (AJOL)

The existence and performance of peer-to-peer systems depend on the contribution of resources .... analysis in P2P based on game strategy. The entire P2P ... a robust P2P systems, every peer must be made to contribute by designing efficient free ..... Currently, all P2P can be classified based on structure as structured and ...

MATIN: a random network coding based framework for high quality peer-to-peer live video streaming.

Science.gov (United States)

Barekatain, Behrang; Khezrimotlagh, Dariush; Aizaini Maarof, Mohd; Ghaeini, Hamid Reza; Salleh, Shaharuddin; Quintana, Alfonso Ariza; Akbari, Behzad; Cabrera, Alicia Triviño

2013-01-01

In recent years, Random Network Coding (RNC) has emerged as a promising solution for efficient Peer-to-Peer (P2P) video multicasting over the Internet. This probably refers to this fact that RNC noticeably increases the error resiliency and throughput of the network. However, high transmission overhead arising from sending large coefficients vector as header has been the most important challenge of the RNC. Moreover, due to employing the Gauss-Jordan elimination method, considerable computational complexity can be imposed on peers in decoding the encoded blocks and checking linear dependency among the coefficients vectors. In order to address these challenges, this study introduces MATIN which is a random network coding based framework for efficient P2P video streaming. The MATIN includes a novel coefficients matrix generation method so that there is no linear dependency in the generated coefficients matrix. Using the proposed framework, each peer encapsulates one instead of n coefficients entries into the generated encoded packet which results in very low transmission overhead. It is also possible to obtain the inverted coefficients matrix using a bit number of simple arithmetic operations. In this regard, peers sustain very low computational complexities. As a result, the MATIN permits random network coding to be more efficient in P2P video streaming systems. The results obtained from simulation using OMNET++ show that it substantially outperforms the RNC which uses the Gauss-Jordan elimination method by providing better video quality on peers in terms of the four important performance metrics including video distortion, dependency distortion, End-to-End delay and Initial Startup delay.

"Until people start dying in droves, no actions will be taken": perception and experience of HIV-preventive measures among people who inject drugs in northwestern Russia.

Science.gov (United States)

Meylakhs, Peter; Aasland, Aadne; Grønningsæter, Arne

2017-06-05

The HIV epidemic among people who inject drugs (PWID) in Russia continues to spread. This exploratory study examines how HIV-prevention measures are perceived and experienced by PWID in the northwestern region of Russia. Purposive sampling was used to obtain a variety of cases that could reflect possible differences in perception and experience of HIV-prevention efforts. We conducted 22 semi-structured interviews with PWID residing in the Arkhangelsk and St. Petersburg regions. The main sources of prevention information on HIV for PWID were media campaigns directed to the general population. These campaigns were effective with regard to communicating general knowledge on HIV but were ineffective in terms of risk behavior change. The subjects generally had trust in medical professionals and their advice but did not follow prevention recommendations. Most informants had no or very little prior contact with harm reduction services. On the level of attitudes towards HIV prevention efforts, we discovered three types of fatalism among PWID: "personal fatalism" - uselessness of HIV prevention efforts, if one uses drugs; "prevention-related fatalism" - prevention programs are low effective, because people do not pay attention to them before they get infected; "state-related fatalism" - the lack of belief that the state is concerned with HIV prevention issues. Despite this fatalism the participants opined that NGOs would do a better job than the state as they are "really working" with risk groups. As HIV prevention campaigns targeted at the general population and prevention advice received from medical professionals are not sufficiently effective for PWID in terms of risk behavior change, prevention programs, such as community-based and peer-based interventions specifically tailored to the needs of PWID are needed, which can be achieved by a large expansion of harm reduction services in the region. Personal communication should be a crucial element in such interventions in

Susceptibility to Peer Influence: Using a Performance-Based Measure to Identify Adolescent Males at Heightened Risk for Deviant Peer Socialization

Science.gov (United States)

Prinstein, Mitchell J.; Brechwald, Whitney A.; Cohen, Geoffrey L.

2011-01-01

A substantial amount of research has suggested that adolescents' attitudes and behaviors are influenced by peers; however, little is known regarding adolescents' individual variability, or susceptibility, to peer influence. In this study, a performance-based index from an experimental paradigm was used to directly measure adolescents'…

Newcomers in a hazardous environment: a qualitative inquiry into sex worker vulnerability to HIV in Bali, Indonesia.

Science.gov (United States)

Januraga, Pande Putu; Mooney-Somers, Julie; Ward, Paul R

2014-08-11

Women new to sex work and those with a greater degree of mobility have higher risk of HIV infection. Using social capital as a theoretical framework, we argue that better understanding of the interactions of micro-level structural factors can be valuable in reshaping and restructuring health promotion programmes in Bali to be more responsive to the concerns and needs of newcomer and mobile female sex workers (FSWs). We conducted interviews with 11 newcomer FSWs (worked six months). The interviews explored women's experience of sex work including how and why they came to sex work, relationships with other FSWs and their HIV prevention practices. A thematic framework analysis revealed newcomer FSWs faced multiple levels of vulnerability that contributed to increased HIV risk. First, a lack of knowledge and self-efficacy about HIV prevention practices was related to their younger age and low exposure to sexual education. Second, on entering sex work, they experienced intensely competitive working environments fuelled by economic competition. This competition reduced opportunities for positive social networks and social learning about HIV prevention. Finally, the lack of social networks and social capital between FSWs undermined peer trust and solidarity, both of which are essential to promote consistent condom use. For example, newcomer FSWs did not trust that if they refused to have sex without a condom, their peers would also refuse; this increased their likelihood of accepting unprotected sex, thereby increasing HIV risk. Public health and social welfare interventions and programmes need to build social networks, social support and solidarity within FSW communities, and provide health education and HIV prevention resources much earlier in women's sex work careers.

Qualitative Research and Community-Based Participatory Research: Considerations for Effective Dissemination in the Peer-Reviewed Literature.

Science.gov (United States)

Grieb, Suzanne Dolwick; Eder, Milton Mickey; Smith, Katherine C; Calhoun, Karen; Tandon, Darius

2015-01-01

Qualitative research is appearing with increasing frequency in the public health and medical literature. Qualitative research in combination with a community-based participatory research (CBPR) approach can be powerful. However little guidance is available on how to present qualitative research within a CBPR framework for peer-review publications. This article provides a brief overview of how qualitative research can advance CBPR partnerships and outlines practical guidelines for writing for publication about qualitative research within a CBPR framework to (1) guide partners with little experience publishing in peer-reviewed journals and/or (2) facilitate effective preparation of manuscripts grounded in qualitative research for peer-reviewed journals. We provide information regarding the specific benefits of qualitative inquiry in CBPR, tips for organizing the manuscript, questions to consider in preparing the manuscript, common mistakes in the presentation of qualitative research, and examples of peer-reviewed manuscripts presenting qualitative research conducted within a CBPR framework. Qualitative research approaches have tremendous potential to integrate community and researcher perspectives to inform community health research findings. Effective dissemination of CBPR informed qualitative research findings is crucial to advancing health disparities research.

Peer-led versus teacher-led AIDS education for female high-school students in Yazd, Islamic Republic of Iran.

Science.gov (United States)

Baghianimoghadam, M H; Forghani, H; Zolghadr, R; Rahaei, Z; Khani, P

2012-04-01

Peer-led programmes on AIDS prevention have shown a good level of effectiveness when tested among high-risk populations. This study compared peer-led and teacher-led methods of education about HIV/AIDS among female high-school students in Yazd city, Islamic Republic of Iran. In 2009 students in 3 high schools were trained by their classmates (peer-led), by the research team (teacher-led) or had no education (controls); 180 students completed a specially designed questionnaire based on the health belief model, before and after the intervention. Post-intervention mean knowledge scores increased 2-fold in the peer-led group, and this was significantly higher than the increase in the teacher-led group scores (1.5-fold). Control group scores were unchanged. In the peer-led programme all of the components of the model were significantly improved whereas in the teacher-led programme, only perceived severity and perceived barriers scored significantly higher after the intervention.

Performance of V3-based HIV-1 sero subtyping in HIV endemic areas

Directory of Open Access Journals (Sweden)

Lara Tavoschi

2011-12-01

Full Text Available HIV-1 serosubtyping based on reactivity to peptides from the V3 region of gp120 is a low-cost and easy to perform procedure often used in geographical areas with high prevalence and incidence of HIV infection. We evaluated the performance of V3-based serotyping on 148 sera from 118 HIV-1-infected individuals living in Uganda, with estimated dates of seroconversion. Of the 148 tested samples, 68 (46.0% specifically reacted with only one of the V3 peptides included in the test (SP, 64 (43.2% did not react with any peptide (NR and 16 (10.8% reacted with two or more peptides (CR. According to the estimated seroconversion date, the large majority of samples collected early after infection belonged to the NR group. These samples had also a low Avidity Index. In contrast, samples collected later after infection belonged mainly to CR and SP groups and had also a higher avidity index. These results indicate that the performance of V3-based assays depends on maturation of HIV-specific immune response and can be significantly lowered when these tests are carried out on specimens collected from recently infected individuals.

Sex, drugs, and HIV: rapid assessment of HIV risk behaviors among street-based drug using sex workers in Durban, South Africa.

Science.gov (United States)

Needle, Richard; Kroeger, Karen; Belani, Hrishikesh; Achrekar, Angeli; Parry, Charles D; Dewing, Sarah

2008-11-01

South Africa is experiencing significant changes in patterns of illicit drug use, including increasing injection and non-injection drug use, and the use of drugs by persons engaged in sex work, both of which could further expand the HIV/AIDS epidemic. In 2005, a rapid ethnographic assessment was conducted in Durban, South Africa, to learn more about patterns of drug use and HIV risk behaviors among drug-using, street-based sex workers. Field teams recruited 52 current injection and non-injection drug users for key informant interviews and focus groups, and they conducted mapping and observation in identified high-risk neighborhoods. Key informants were offered free, voluntary counseling and HIV rapid testing. The results of the assessment indicate that in this population, drugs play an organizing role in patterns of daily activities, with sex work closely linked to the buying, selling, and using of drugs. Participants reported using multiple drugs including crack cocaine, heroin, Ecstasy and Mandrax, and their choices were based on their expectations about the functional role and behavioral and pharmacological properties of the drugs. The organization of sex work and patterns of drug use differ by gender, with males exercising more control over daily routines and drug and sexual transactions than females. Activities of female sex workers are subject to considerable control by individual pimps, many of whom also function as landlords and drug dealers. A strong hold over the overlapping economies of drugs and sex work by a few individuals extends to control of the physical and social settings in which sex is exchanged and drugs are sold and used as well as the terms under which sex work is carried out. The potential for accelerated HIV spread is considerable given the evidence of overlapping drug-using and sexual risk behaviors and the mixing patterns across drug and sexual risk networks.

Development of leadership self-efficacy and collective efficacy: adolescent girls across castes as peer educators in Nepal.

Science.gov (United States)

Posner, J; Kayastha, P; Davis, D; Limoges, J; O'Donnell, C; Yue, K

2009-01-01

Adolescent girls in Nepal face enormous social barriers to accessing education and health services due to exclusionary socio-religious traditions and years of conflict. The programme and study reported here address two issues that a national assembly of in-school and out-of-school adolescent girls, who had completed a basic life skills class, and, in the case of unschooled girls, an intensive literacy course, identified as important to their well-being - menstrual restrictions and HIV awareness and prevention. Local non-governmental organizations developed a peer education programme in three districts of Nepal that paired girls from different castes and different educational levels. The programme sought to increase peer educators' (PE) leadership and collective efficacy for informing peers and adults in their communities about the effects that these issues have on women and girls. In total, 504 girls were selected and trained as PEs. They conducted targeted discussion sessions with other girls and organised mass awareness events, reaching 20,000 people. Examination of the effects of participating in the programme on key outcome measures showed that leadership self-efficacy, which was a central theoretical construct for the programme, provided a strong predictor of both increased HIV knowledge and of practicing fewer menstrual restrictions at endline. The project demonstrated that girls from different caste and educational backgrounds are able to work together to change individual behaviour and to address socio-cultural norms that affect their lives and well-being within their communities.

Community burden of undiagnosed HIV infection among adolescents in Zimbabwe following primary healthcare-based provider-initiated HIV testing and counselling: A cross-sectional survey.

Directory of Open Access Journals (Sweden)

Victoria Simms

2017-07-01

Full Text Available Children living with HIV who are not diagnosed in infancy often remain undiagnosed until they present with advanced disease. Provider-initiated testing and counselling (PITC in health facilities is recommended for high-HIV-prevalence settings, but it is unclear whether this approach is sufficient to achieve universal coverage of HIV testing. We aimed to investigate the change in community burden of undiagnosed HIV infection among older children and adolescents following implementation of PITC in Harare, Zimbabwe.Over the course of 2 years (January 2013-January 2015, 7 primary health clinics (PHCs in southwestern Harare implemented optimised, opt-out PITC for all attendees aged 6-15 years. In February 2015-December 2015, we conducted a representative cross-sectional survey of 8-17-year-olds living in the 7 communities served by the study PHCs, who would have had 2 years of exposure to PITC. Knowledge of HIV status was ascertained through a caregiver questionnaire, and anonymised HIV testing was carried out using oral mucosal transudate (OMT tests. After 1 participant taking antiretroviral therapy was observed to have a false negative OMT result, from July 2015 urine samples were obtained from all participants providing OMTs and tested for antiretroviral drugs to confirm HIV status. Children who tested positive through PITC were identified from among survey participants using gender, birthdate, and location. Of 7,146 children in 4,251 eligible households, 5,486 (76.8% children in 3,397 households agreed to participate in the survey, and 141 were HIV positive. HIV prevalence was 2.6% (95% CI 2.2%-3.1%, and over a third of participants with HIV were undiagnosed (37.7%; 95% CI 29.8%-46.2%. Similarly, among the subsample of 2,643 (48.2% participants with a urine test result, 34.7% of those living with HIV were undiagnosed (95% CI 23.5%-47.9%. Based on extrapolation from the survey sample to the community, we estimated that PITC over 2 years identified

Peer assessment of student-produced mechanics lab report videos

Science.gov (United States)

Douglas, Scott S.; Aiken, John M.; Lin, Shih-Yin; Greco, Edwin F.; Alicea-Muñoz, Emily; Schatz, Michael F.

2017-12-01

We examine changes in students' rating behavior during a semester-long sequence of peer evaluation laboratory exercises in an introductory mechanics course. We perform a quantitative analysis of the ratings given by students to peers' physics lab reports, and conduct interviews with students. We find that peers persistently assign higher ratings to lab reports than do experts, that peers begin the semester by giving high ratings most frequently and end the semester with frequent middle ratings, and that peers go through the semester without much change in the frequency of low ratings. We then use student interviews to develop a model for student engagement with peer assessment. This model is based on two competing influences which appear to shape peer evaluation behavior: a strong disinclination to give poor ratings with a complementary preference to give high ratings when in doubt, and an attempt to develop an expertlike criticality when assessing peers' work.

Healthy Aging in Older Women Living with HIV Infection: a Systematic Review of Psychosocial Factors.

Science.gov (United States)

Rubtsova, Anna A; Kempf, Mirjam-Colette; Taylor, Tonya N; Konkle-Parker, Deborah; Wingood, Gina M; Holstad, Marcia McDonnell

2017-02-01

Due to life-enhancing effects of antiretroviral therapy, HIV-positive persons have the potential for long life comparable to their uninfected peers. Older women (age 50+) living with HIV (OWLH) are often an under-recognized aging group. We conducted a systematic review to examine psychosocial factors that impact how OWLH live, cope, and age with HIV. Initial key word search yielded 1527 records, and 21 studies met our inclusion criteria of original quantitative or qualitative research published between 2013 and 2016 with results specific to OWLH. These focused on health care and self-management, sexual health and risk, stigma, loneliness, mental health (depression, substance use), and protective factors (coping, social support, well-being). Due to the scarcity of studies on each topic and inconclusive findings, no clear patterns of results emerged. As the number of OWLH continues to grow, more research, including longitudinal studies, is needed to fully characterize the psychosocial factors that impact aging with HIV.

Comparing Measures of Late HIV Diagnosis in Washington State

Directory of Open Access Journals (Sweden)

Laura Saganic

2012-01-01

Full Text Available As more US HIV surveillance programs routinely use late HIV diagnosis to monitor and characterize HIV testing patterns, there is an increasing need to standardize how late HIV diagnosis is measured. In this study, we compared two measures of late HIV diagnosis, one based on time between HIV and AIDS, the other based on initial CD4+ results. Using data from Washington's HIV/AIDS Reporting System, we used multivariate logistic regression to identify predictors of late HIV diagnosis. We also conducted tests for trend to determine whether the proportion of cases diagnosed late has changed over time. Both measures lead us to similar conclusions about late HIV diagnosis, suggesting that being male, older, foreign-born, or heterosexual increase the likelihood of late HIV diagnosis. Our findings reaffirm the validity of a time-based definition of late HIV diagnosis, while at the same time demonstrating the potential value of a lab-based measure.

Preferences for Home-Based HIV Testing Among Heterosexuals at Increased Risk for HIV/AIDS: New Orleans, Louisiana, 2013.

Science.gov (United States)

Robinson, William T; Zarwell, Meagan; Gruber, DeAnn

2017-07-01

Participants in the New Orleans arm of the National HIV Behavioral Surveillance of Heterosexuals at Increased Risk for HIV were asked about potential utilization of self-administered home-based tests for HIV. The majority (86%) would use a free home-based test if provided by mail and 99% would seek treatment based on a positive result. In addition, more than half of respondents would return test results in some format to the test provider, whereas most of the remaining participants preferred to discuss results only with their doctor. These findings point toward a potential method for advancing the National HIV/AIDS Strategy.

MATIN: a random network coding based framework for high quality peer-to-peer live video streaming.

Directory of Open Access Journals (Sweden)

Behrang Barekatain

Full Text Available In recent years, Random Network Coding (RNC has emerged as a promising solution for efficient Peer-to-Peer (P2P video multicasting over the Internet. This probably refers to this fact that RNC noticeably increases the error resiliency and throughput of the network. However, high transmission overhead arising from sending large coefficients vector as header has been the most important challenge of the RNC. Moreover, due to employing the Gauss-Jordan elimination method, considerable computational complexity can be imposed on peers in decoding the encoded blocks and checking linear dependency among the coefficients vectors. In order to address these challenges, this study introduces MATIN which is a random network coding based framework for efficient P2P video streaming. The MATIN includes a novel coefficients matrix generation method so that there is no linear dependency in the generated coefficients matrix. Using the proposed framework, each peer encapsulates one instead of n coefficients entries into the generated encoded packet which results in very low transmission overhead. It is also possible to obtain the inverted coefficients matrix using a bit number of simple arithmetic operations. In this regard, peers sustain very low computational complexities. As a result, the MATIN permits random network coding to be more efficient in P2P video streaming systems. The results obtained from simulation using OMNET++ show that it substantially outperforms the RNC which uses the Gauss-Jordan elimination method by providing better video quality on peers in terms of the four important performance metrics including video distortion, dependency distortion, End-to-End delay and Initial Startup delay.

A new analytical framework of 'continuum of prevention and care' to maximize HIV case detection and retention in care in Vietnam

Directory of Open Access Journals (Sweden)

Fujita Masami

2012-12-01

Full Text Available Abstract Background The global initiative ‘Treatment 2.0’ calls for expanding the evidence base of optimal HIV service delivery models to maximize HIV case detection and retention in care. However limited systematic assessment has been conducted in countries with concentrated HIV epidemic. We aimed to assess HIV service availability and service connectedness in Vietnam. Methods We developed a new analytical framework of the continuum of prevention and care (COPC. Using the framework, we examined HIV service delivery in Vietnam. Specifically, we analyzed HIV service availability including geographical distribution and decentralization and service connectedness across multiple services and dimensions. We then identified system-related strengths and constraints in improving HIV case detection and retention in care. This was accomplished by reviewing related published and unpublished documents including existing service delivery data. Results Identified strengths included: decentralized HIV outpatient clinics that offer comprehensive care at the district level particularly in high HIV burden provinces; functional chronic care management for antiretroviral treatment (ART with the involvement of people living with HIV and the links to community- and home-based care; HIV testing and counseling integrated into tuberculosis and antenatal care services in districts supported by donor-funded projects, and extensive peer outreach networks that reduce barriers for the most-at-risk populations to access services. Constraints included: fragmented local coordination mechanisms for HIV-related health services; lack of systems to monitor the expansion of HIV outpatient clinics that offer comprehensive care; underdevelopment of pre-ART care; insufficient linkage from HIV testing and counseling to pre-ART care; inadequate access to HIV-related services in districts not supported by donor-funded projects particularly in middle and low burden provinces and in

Home-Based HIV Testing and Counseling for Male Couples (Project Nexus): A Protocol for a Randomized Controlled Trial.

Science.gov (United States)

Stephenson, Rob; Freeland, Ryan; Sullivan, Stephen P; Riley, Erin; Johnson, Brent A; Mitchell, Jason; McFarland, Deborah; Sullivan, Patrick S

2017-05-30

HIV prevalence remains high among men who have sex with men (MSM) in the United States, yet the majority of research has focused on MSM as individuals, not as dyads, and has discussed HIV risks primarily in the context of casual sex. Nexus is an online prevention program that combines home-based HIV testing and couples HIV testing and counseling (CHTC). It allows partners in dyadic MSM relationships to receive HIV testing and care in the comfort of their designated residence, via video-based chat. By using video-based technologies (eg, VSee video chat), male couples receive counseling and support from a remote online counselor, while testing for HIV at home. This randomized control trial (RCT) aims to examine the effects of video-based counseling combined with home-based HIV testing on couples' management of HIV risk, formation and adherence to explicit sexual agreements, and sexual risk-taking. The research implements a prospective RCT of 400 online-recruited male couples: 200 self-reported concordant-negative couples and 200 self-reported discordant couples. Couples in the control arm will receive one or two home-based HIV self-testing kits and will be asked to report their results via the study's website. Couples in the experimental arm will receive one or two home-based HIV self-testing kits and will conduct these tests together under the facilitation of a remotely located counselor during a prescheduled VSee-based video CHTC session. Study assessments are taken at baseline, as well as at 3- and 6-month follow-up sessions. Project Nexus was launched in April 2016 and is ongoing. To date, 219 eligible couples have been enrolled and randomized. Combining home-based HIV testing with video-based counseling creates an opportunity to expand CHTC to male couples who (1) live outside metro areas, (2) live in rural areas without access to testing services or LGBTQ resources, or (3) feel that current clinic-based testing is not for them (eg, due to fears of

mitigating mitigating free riding in peer-to-peer networks

African Journals Online (AJOL)

eobe

The performance of peer-to-peer systems is based on the quality and quantity of resource contributions from peer systems ... riding [3]. There are several measurement studies ...... J. S. Hua, D. C. Huang, S M Yen, and C. W. Chena, “A dynamic.

MO-E-18C-01: Open Access Web-Based Peer-To-Peer Training and Education in Radiotherapy

International Nuclear Information System (INIS)

Pawlicki, T; Brown, D; Dunscombe, P; Mutic, S

2014-01-01

Purpose: Current training and education delivery models have limitations which result in gaps in clinical proficiency with equipment, procedures, and techniques. Educational and training opportunities offered by vendors and professional societies are by their nature not available at point of need or for the life of clinical systems. The objective of this work is to leverage modern communications technology to provide peer-to-peer training and education for radiotherapy professionals, in the clinic and on demand, as they undertake their clinical duties. Methods: We have developed a free of charge web site ( https://i.treatsafely.org ) using the Google App Engine and datastore (NDB, GQL), Python with AJAX-RPC, and Javascript. The site is a radiotherapy-specific hosting service to which user-created videos illustrating clinical or physics processes and other relevant educational material can be uploaded. Efficient navigation to the material of interest is provided through several RT specific search tools and videos can be scored by users, thus providing comprehensive peer review of the site content. The site also supports multilingual narration\\translation of videos, a quiz function for competence assessment and a library function allowing groups or institutions to define their standard operating procedures based on the video content. Results: The website went live in August 2013 and currently has over 680 registered users from 55 countries; 27.2% from the United States, 9.8% from India, 8.3% from the United Kingdom, 7.3% from Brazil, and 47.5% from other countries. The users include physicists (57.4%), Oncologists (12.5%), therapists (8.2%) and dosimetrists (4.8%). There are 75 videos to date including English, Portuguese, Mandarin, and Thai. Conclusion: Based on the initial acceptance of the site, we conclude that this open access web-based peer-to-peer tool is fulfilling an important need in radiotherapy training and education. Site functionality should expand in

MO-E-18C-01: Open Access Web-Based Peer-To-Peer Training and Education in Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Pawlicki, T [UC San Diego Medical Center, La Jolla, CA (United States); Brown, D; Dunscombe, P [Tom Baker Cancer Centre, Calgary, AB (Canada); Mutic, S [Washington University School of Medicine, Saint Louis, MO (United States)

2014-06-15

Purpose: Current training and education delivery models have limitations which result in gaps in clinical proficiency with equipment, procedures, and techniques. Educational and training opportunities offered by vendors and professional societies are by their nature not available at point of need or for the life of clinical systems. The objective of this work is to leverage modern communications technology to provide peer-to-peer training and education for radiotherapy professionals, in the clinic and on demand, as they undertake their clinical duties. Methods: We have developed a free of charge web site ( https://i.treatsafely.org ) using the Google App Engine and datastore (NDB, GQL), Python with AJAX-RPC, and Javascript. The site is a radiotherapy-specific hosting service to which user-created videos illustrating clinical or physics processes and other relevant educational material can be uploaded. Efficient navigation to the material of interest is provided through several RT specific search tools and videos can be scored by users, thus providing comprehensive peer review of the site content. The site also supports multilingual narration\\translation of videos, a quiz function for competence assessment and a library function allowing groups or institutions to define their standard operating procedures based on the video content. Results: The website went live in August 2013 and currently has over 680 registered users from 55 countries; 27.2% from the United States, 9.8% from India, 8.3% from the United Kingdom, 7.3% from Brazil, and 47.5% from other countries. The users include physicists (57.4%), Oncologists (12.5%), therapists (8.2%) and dosimetrists (4.8%). There are 75 videos to date including English, Portuguese, Mandarin, and Thai. Conclusion: Based on the initial acceptance of the site, we conclude that this open access web-based peer-to-peer tool is fulfilling an important need in radiotherapy training and education. Site functionality should expand in

Preventing DoS attacks in peer-to-peer media streaming systems

Science.gov (United States)

Conner, William; Nahrstedt, Klara; Gupta, Indranil

2006-01-01

This paper presents a framework for preventing both selfishness and denial-of-service attacks in peer-to-peer media streaming systems. Our framework, called Oversight, achieves prevention of these undesirable activities by running a separate peer-to-peer download rate enforcement protocol along with the underlying peer-to-peer media streaming protocol. This separate Oversight protocol enforces download rate limitations on each participating peer. These limitations prevent selfish or malicious nodes from downloading an overwhelming amount of media stream data that could potentially exhaust the entire system. Since Oversight is based on a peer-to-peer architecture, it can accomplish this enforcement functionality in a scalable, efficient, and decentralized way that fits better with peer-to-peer media streaming systems compared to other solutions based on central server architectures. As peer-to-peer media streaming systems continue to grow in popularity, the threat of selfish and malicious peers participating in such large peer-to-peer networks will continue to grow as well. For example, since peer-to-peer media streaming systems allow users to send small request messages that result in the streaming of large media objects, these systems provide an opportunity for malicious users to exhaust resources in the system with little effort expended on their part. However, Oversight addresses these threats associated with selfish or malicious peers who cause such disruptions with excessive download requests. We evaluated our Oversight solution through simulations and our results show that applying Oversight to peer-to-peer media streaming systems can prevent both selfishness and denial-of-service attacks by effectively limiting the download rates of all nodes in the system.

HIV infection and sexual risk among men who have sex with men and women (MSMW: a systematic review and meta-analysis.

Directory of Open Access Journals (Sweden)

M Reuel Friedman

Full Text Available OBJECTIVES: To estimate the number of men who have sex with men and women who are HIV-positive in the United States, and to compare HIV prevalence rates between men who have sex with men and women, men who have sex with men only, and men who have sex with women exclusively. METHODS: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of reports referencing HIV prevalence and men who have sex with men and women. We searched PubMed and Ovid PsycINFO for peer-reviewed, U.S.-based articles reporting on HIV prevalence among men who have sex with men and women. We conducted event rate, effect size, moderation and sensitivity analyses. RESULTS: We estimate that 1.0% of U.S. males are bisexually-behaving, and that 121,800 bisexually-behaving men are HIV-positive. Men who have sex with men and women are less than half as likely to be HIV-positive as men who have sex with men only (16.9% vs. 33.3%; OR = 0.41, 95% CI: 0.31, 0.54, but more than five times as likely to be HIV-positive as men who have sex with women exclusively (18.3% vs. 3.5%; OR = 5.71, 95% CI: 3.47, 9.39. They are less likely to engage in unprotected receptive anal intercourse than men who have sex with men only (15.9% vs. 35.0%; OR = 0.36, 95% CI: 0.28, 0.46. Men who have sex with men and women in samples with high racial/ethnic minority proportions had significantly higher HIV prevalence than their counterparts in low racial/ethnic minority samples. CONCLUSIONS: This represents the first meta-analysis of HIV prevalence in the U.S. between men who have sex with men and women and men who have sex with men only. Data collection, research, and HIV prevention and care delivery specifically tailored to men who have sex with men and women are necessary to better quantify and ameliorate this population's HIV burden.

Short term effectiveness and experiences of a peer guided web-based self-management intervention for young adults with juvenile idiopathic arthritis

NARCIS (Netherlands)

J. Ammerlaan (Judy); H. van Os-Medendorp (Harmieke); de Boer-Nijhof, N. (Nienke); Scholtus, L. (Lieske); A.A. Kruize (Aike); P.A. van Pelt (Philomine); B.J. Prakken (Berent); J.W.J. Bijlsma (Hans)

2017-01-01

textabstractBackground: A web-based self-management intervention guided by peer-trainers was developed to support young adults' self-management in coping with Juvenile Idiopathic Arthritis (JIA). To investigate its effectiveness, a randomized controlled trial (RCT) was conducted. In addition, the

Psychological Resilience among Children Affected by Parental HIV/AIDS: A Conceptual Framework.

Science.gov (United States)

Li, Xiaoming; Chi, Peilian; Sherr, Lorraine; Cluver, Lucie; Stanton, Bonita

2015-01-01

HIV-related parental illness and death have a profound and lasting impact on a child's psychosocial wellbeing, potentially compromising the child's future. In response to a paucity of theoretical and conceptual discussions regarding the development of resilience among children affected by parental HIV, we proposed a conceptual framework of psychological resilience among children affected by HIV based on critical reviews of the existing theoretical and empirical literature. Three interactive social ecological factors were proposed to promote the resilience processes and attenuate the negative impact of parental HIV on children's psychological development. Internal assets, such as cognitive capacity, motivation to adapt, coping skills, religion/spirituality, and personality, promote resilience processes. Family resources and community resources are two critical contextual factors that facilitate resilience process. Family resources contain smooth transition, functional caregivers, attachment relationship, parenting discipline. Community resources contain teacher support, peer support, adult mentors, and effective school. The implications of the conceptual framework for future research and interventions among children affected by parental HIV were discussed.

Psychological Resilience among Children Affected by Parental HIV/AIDS: A Conceptual Framework

Science.gov (United States)

Li, Xiaoming; Chi, Peilian; Sherr, Lorraine; Cluver, Lucie; Stanton, Bonita

2015-01-01

HIV-related parental illness and death have a profound and lasting impact on a child's psychosocial wellbeing, potentially compromising the child's future. In response to a paucity of theoretical and conceptual discussions regarding the development of resilience among children affected by parental HIV, we proposed a conceptual framework of psychological resilience among children affected by HIV based on critical reviews of the existing theoretical and empirical literature. Three interactive social ecological factors were proposed to promote the resilience processes and attenuate the negative impact of parental HIV on children's psychological development. Internal assets, such as cognitive capacity, motivation to adapt, coping skills, religion/spirituality, and personality, promote resilience processes. Family resources and community resources are two critical contextual factors that facilitate resilience process. Family resources contain smooth transition, functional caregivers, attachment relationship, parenting discipline. Community resources contain teacher support, peer support, adult mentors, and effective school. The implications of the conceptual framework for future research and interventions among children affected by parental HIV were discussed. PMID:26716068

Social Workers' Attitudes toward Peer-Reviewed Literature: The Evidence Base

Science.gov (United States)

Knight, Carolyn

2013-01-01

Social workers from one state chapter of the National Association of Social Workers were surveyed to assess their use of and attitudes toward the peer-reviewed literature and their engagement in evidence-based practice. Results reveal that, in general, the practitioners in this study did not read the peer-reviewed literature, particularly articles…

Prevalence and risk factors for child mental disorders in a population-based cohort of HIV-exposed and unexposed African children aged 7-11 years.

Science.gov (United States)

Rochat, Tamsen J; Houle, Brian; Stein, Alan; Pearson, Rebecca M; Bland, Ruth M

2018-04-21

Despite being home to a large population of vulnerable children there is a dearth of population-based evidence on childhood mental disorders in sub-Saharan Africa. Parent and child mental health are rarely measured concurrently, despite potential for confounding with other risk factors, including parental HIV. Using the parent-report Child Behaviour Checklist (CBCL) we assessed children's mental health in a population-based cohort of 1536 HIV-negative children (31% HIV-exposed, 18% HIV-affected, 51% HIV-unexposed) aged 7-11 years. CBCL was scored using CBCL Rating-to-Score software. A binary indicator was determined using the clinical threshold ≥ 65. We modelled mental disorders using logistic regression, including covariates associated with the mother, child, household, and parenting. Structural equation modelling techniques also derived continuous latent variables representing the underlying mental health and parent-relationship constructs. Prevalence of conduct disorders (11.8%) was high, regardless of HIV exposure, while HIV-affected children had increased odds of affective disorders. Maternal depression increased odds of externalising disorders; maternal anxiety was associated with affective and anxiety disorders. Mother-child relationship dysfunction increased odds of all disorders, including: affective [aOR = 5.1 (2.6-9.9)]; oppositional [aOR = 7.9 (4.0-15.5)]; conduct [aOR = 4.3 (2.6-7.2)] disorders. Food insecurity and male gender increased odds of somatic disorders; breastfeeding halved odds of conduct disorders. In the latent model, associations were substantially stronger for the mother-child relationship and externalising disorders (Oppositional 0.464 p Conduct 0.474 p = Conduct disorders were high for all children regardless of HIV exposure. The mother-child relationship was strongly related to all child disorders, suggesting potential for concurrent interventions targeting child behaviours and the parent-child or mother

Appreciative inquiry into lifeskills-based HIV/AIDS education in ...

African Journals Online (AJOL)

With a steady rise in the prevalence of HIV and AIDS throughout the world it has become vital for programme implementers at all levels to ensure that all HIV intervention programmes are effectively put into practice. The present research used qualitative and quantitative data to evaluate the lifeskills-based HIV/AIDS ...

A Randomized Controlled Trial Evaluating Efficacy of Promoting a Home-Based HIV Self-Testing with Online Counseling on Increasing HIV Testing Among Men Who Have Sex with Men.

Science.gov (United States)

Wang, Zixin; Lau, Joseph T F; Ip, Mary; Ho, Shara P Y; Mo, Phoenix K H; Latkin, Carl; Ma, Yee Ling; Kim, Yoona

2018-01-01

We developed an innovative home-based HIV self-testing (HIVST) service that included mailing of a free HIVST kit, and providing online real-time instructions and pre-test/post-test counseling (HIVST-OIC). The present parallel-group and non-blinded randomized controlled trial was conducted to evaluate the efficacy of promoting HIVST-OIC in increasing HIV testing rate among 430 men who have sex with men (MSM), with access to online live-chat applications in Hong Kong. At month 6, as compared to the control group, the intervention group reported significantly higher prevalence of HIV testing of any type (89.8 vs. 50.7%; relative risk (RR): 1.77; p strong potential in increasing prevalence of HIV testing and reducing sexual risk behaviors. Implementation research is warranted.

Same day ART initiation versus clinic-based pre-ART assessment and counselling for individuals newly tested HIV-positive during community-based HIV testing in rural Lesotho - a randomized controlled trial (CASCADE trial).

Science.gov (United States)

Labhardt, Niklaus Daniel; Ringera, Isaac; Lejone, Thabo Ishmael; Masethothi, Phofu; Thaanyane, T'sepang; Kamele, Mashaete; Gupta, Ravi Shankar; Thin, Kyaw; Cerutti, Bernard; Klimkait, Thomas; Fritz, Christiane; Glass, Tracy Renée

2016-04-14

Achievement of the UNAIDS 90-90-90 targets in Sub-Sahara Africa is challenged by a weak care-cascade with poor linkage to care and retention in care. Community-based HIV testing and counselling (HTC) is widely used in African countries. However, rates of linkage to care and initiation of antiretroviral therapy (ART) in individuals who tested HIV-positive are often very low. A frequently cited reason for non-linkage to care is the time-consuming pre-ART assessment often requiring several clinic visits before ART-initiation. This two-armed open-label randomized controlled trial compares in individuals tested HIV-positive during community-based HTC the proposition of same-day community-based ART-initiation to the standard of care pre-ART assessment at the clinic. Home-based HTC campaigns will be conducted in catchment areas of six clinics in rural Lesotho. Households where at least one individual tested HIV positive will be randomized. In the standard of care group individuals receive post-test counselling and referral to the nearest clinic for pre-ART assessment and counselling. Once they have started ART the follow-up schedule foresees monthly clinic visits. Individuals randomized to the intervention group receive on the spot point-of-care pre-ART assessment and adherence counselling with the proposition to start ART that same day. Once they have started ART, follow-up clinic visits will be less frequent. First primary outcome is linkage to care (individual presents at the clinic at least once within 3 months after the HIV test). The second primary outcome is viral suppression 12 months after enrolment in the study. We plan to enrol a minimum of 260 households with 1:1 allocation and parallel assignment into both arms. This trial will show if in individuals tested HIV-positive during community-based HTC campaigns the proposition of same-day ART initiation in the community, combined with less frequent follow-up visits at the clinic could be a pragmatic approach to

6. Impact of HIV Information and Peer Support

African Journals Online (AJOL)

Esem

rate of psychiatric disorders among HIV infected youths. Acute distress usually starts .... reduced to mild depression in only eight (8) of the eighty. (80) children after the ... child with social withdrawal had serious skin lesions. There was a further ...

An Agent-Based Model of Private Woodland Owner Management Behavior Using Social Interactions, Information Flow, and Peer-To-Peer Networks.

Directory of Open Access Journals (Sweden)

Emily Silver Huff

Full Text Available Privately owned woodlands are an important source of timber and ecosystem services in North America and worldwide. Impacts of management on these ecosystems and timber supply from these woodlands are difficult to estimate because complex behavioral theory informs the owner's management decisions. The decision-making environment consists of exogenous market factors, internal cognitive processes, and social interactions with fellow landowners, foresters, and other rural community members. This study seeks to understand how social interactions, information flow, and peer-to-peer networks influence timber harvesting behavior using an agent-based model. This theoretical model includes forested polygons in various states of 'harvest readiness' and three types of agents: forest landowners, foresters, and peer leaders (individuals trained in conservation who use peer-to-peer networking. Agent rules, interactions, and characteristics were parameterized with values from existing literature and an empirical survey of forest landowner attitudes, intentions, and demographics. The model demonstrates that as trust in foresters and peer leaders increases, the percentage of the forest that is harvested sustainably increases. Furthermore, peer leaders can serve to increase landowner trust in foresters. Model output and equations will inform forest policy and extension/outreach efforts. The model also serves as an important testing ground for new theories of landowner decision making and behavior.

Are cultural values and beliefs included in U.S. based HIV interventions?

OpenAIRE

Wyatt, GE; Williams, JK; Gupta, A; Malebranche, D

2012-01-01

Objective: To determine the extent to which current United States based human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention and risk reduction interventions address and include aspects of cultural beliefs in definitions, curricula, measures and related theories that may contradict current safer sex messages. Method: A comprehensive literature review was conducted to determine which published human immunodeficiency virus/acquired immune deficiency syndrome (H...

Assessment of contamination and misclassification biases in a randomized controlled trial of a social network peer education intervention to reduce HIV risk behaviors among drug users and risk partners in Philadelphia, PA and Chiang Mai, Thailand.

Science.gov (United States)

Simmons, Nicole; Donnell, Deborah; Ou, San-San; Celentano, David D; Aramrattana, Apinun; Davis-Vogel, Annet; Metzger, David; Latkin, Carl

2015-10-01

Controlled trials of HIV prevention and care interventions are susceptible to contamination. In a randomized controlled trial of a social network peer education intervention among people who inject drugs and their risk partners in Philadelphia, PA and Chiang Mai, Thailand, we tested a contamination measure based on recall of intervention terms. We assessed the recall of test, negative and positive control terms among intervention and control arm participants and compared the relative odds of recall of test versus negative control terms between study arms. The contamination measures showed good discriminant ability among participants in Chiang Mai. In Philadelphia there was no evidence of contamination and little evidence of diffusion. In Chiang Mai there was strong evidence of diffusion and contamination. Network structure and peer education in Chiang Mai likely led to contamination. Recall of intervention materials can be a useful method to detect contamination in experimental interventions.

Predictors of sharing injection equipment by HIV-seropositive injection drug users.

Science.gov (United States)

Latkin, Carl A; Buchanan, Amy S; Metsch, Lisa R; Knight, Kelly; Latka, Mary H; Mizuno, Yuko; Knowlton, Amy R

2008-12-01

Among HIV-positive injection drug users (IDUs), we examined baseline predictors of lending needles and syringes and sharing cookers, cotton, and rinse water in the prior 3 months at follow-up. Participants were enrolled in Intervention for Seropositive Injectors-Research and Evaluation, a secondary prevention intervention for sexually active HIV-positive IDUs in 4 US cities during 2001-2005. The analyses involved 357 participants who reported injecting drugs in the prior 6 months at either the 6- or 12-month follow-up visit. About half (49%) reported at least 1 sharing episode. In adjusted analyses, peer norms supporting safer injection practices and having primary HIV medical care visits in the prior 6 months were associated with reporting no sharing of injection equipment. Higher levels of psychological distress were associated with a greater likelihood of reporting drug paraphernalia sharing. These findings suggest that intervention approaches for reducing HIV-seropositive IDUs' transmission of blood-borne infections should include peer-focused interventions to alter norms of drug paraphernalia sharing and promoting primary HIV care and mental health services.

Characteristics of participants in an HIV prevention intervention for youth in Rwanda: results from a longitudinal study

Directory of Open Access Journals (Sweden)

Hanne Celis

2014-08-01

Full Text Available Introduction. This paper studies determinants of participation in a peer-led school-based HIV prevention intervention in Rwanda. Methods. A baseline survey among 1071 students (mean age 17 years assessed potential determinants of participation, while a follow-up six months in the intervention measured actual participation in the intervention. Statistical models were built using multivariate linear and multinomial regression analysis predicting overall participation, par- ticipation in group discussions and individual counseling. Results. Those who recently had sex, had been tested for HIV, feel more susceptible to HIV, have a higher sexual self-concept, a more positive future perspective (only for non-sexually active, and boys, were more likely to participate in group activities. Also students from the same class as the peer educator and boarding school students were more likely to participate in group activities. Older students and those with low external health locus of control participated more in individual counseling. Discussion. Participation could be increased by investing in general well-being of young people, organizing girls-only activities, and diversifying activities. Key words: selection bias, HIV prevention, participation rate, young people, Rwanda

Estimating peer density effects on oral health for community-based older adults.

Science.gov (United States)

Chakraborty, Bibhas; Widener, Michael J; Mirzaei Salehabadi, Sedigheh; Northridge, Mary E; Kum, Susan S; Jin, Zhu; Kunzel, Carol; Palmer, Harvey D; Metcalf, Sara S

2017-12-29

As part of a long-standing line of research regarding how peer density affects health, researchers have sought to understand the multifaceted ways that the density of contemporaries living and interacting in proximity to one another influence social networks and knowledge diffusion, and subsequently health and well-being. This study examined peer density effects on oral health for racial/ethnic minority older adults living in northern Manhattan and the Bronx, New York, NY. Peer age-group density was estimated by smoothing US Census data with 4 kernel bandwidths ranging from 0.25 to 1.50 mile. Logistic regression models were developed using these spatial measures and data from the ElderSmile oral and general health screening program that serves predominantly racial/ethnic minority older adults at community centers in northern Manhattan and the Bronx. The oral health outcomes modeled as dependent variables were ordinal dentition status and binary self-rated oral health. After construction of kernel density surfaces and multiple imputation of missing data, logistic regression analyses were performed to estimate the effects of peer density and other sociodemographic characteristics on the oral health outcomes of dentition status and self-rated oral health. Overall, higher peer density was associated with better oral health for older adults when estimated using smaller bandwidths (0.25 and 0.50 mile). That is, statistically significant relationships (p density and improved dentition status were found when peer density was measured assuming a more local social network. As with dentition status, a positive significant association was found between peer density and fair or better self-rated oral health when peer density was measured assuming a more local social network. This study provides novel evidence that the oral health of community-based older adults is affected by peer density in an urban environment. To the extent that peer density signifies the potential for

Cooptation of Peer Support Staff: Quantitative Evidence

Directory of Open Access Journals (Sweden)

Anthony J. Alberta

2014-03-01

Full Text Available Objective In 2007, the Centers for Medicare and Medicaid Services (CMS sent a letter to state Medicaid directors outlining requirements for implementing peer-based recovery support services (P-BRSS as a Medicaid-funded service. Since then, 30 states have implemented these services. Although the literature describing implementation of P-BRSS has identified the cooptation of peer support staff (PSS as a barrier to the effective provision of P-BRSS, the evidence for it remains anecdotal. This study attempts to determine if the context of employment in either a treatment organization or peer organization affected cooptation. Methods We conducted a survey of PSS in the fall of 2013. In all, 92 of the 181 respondents were working as PSS at the time, 53 in treatment organizations. Chi-square analysis was used to determine if the context of employment had an effect on the cooptation of peer staff. Results Peer staff working in treatment organizations reported that they were supervised by treatment staff and participated in employment-related training to improve their skills at providing treatment services more frequently than their counterparts in peer organizations. Peer staff working in treatment organizations also participated in training and education to prepare for employment as treatment professionals more frequently than peer staff working in peer organizations. Conclusions and Implications for Practice Peer staff members working in treatment organizations are subject to processes of acculturation into professional cultures that peer staff working in peer organizations are not. Effective implementation of P-BRSS should include specific efforts to minimize the cooptation of peer staff.

Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults

Science.gov (United States)

Günthard, Huldrych F.; Saag, Michael S.; Benson, Constance A.; del Rio, Carlos; Eron, Joseph J.; Gallant, Joel E.; Hoy, Jennifer F.; Mugavero, Michael J.; Sax, Paul E.; Thompson, Melanie A.; Gandhi, Rajesh T.; Landovitz, Raphael J.; Smith, Davey M.; Jacobsen, Donna M.; Volberding, Paul A.

2016-01-01

IMPORTANCE New data and therapeutic options warrant updated recommendations for the use of antiretroviral drugs (ARVs) to treat or to prevent HIV infection in adults. OBJECTIVE To provide updated recommendations for the use of antiretroviral therapy in adults (aged ≥18 years) with established HIV infection, including when to start treatment, initial regimens, and changing regimens, along with recommendations for using ARVs for preventing HIV among those at risk, including preexposure and postexposure prophylaxis. EVIDENCE REVIEW A panel of experts in HIV research and patient care convened by the International Antiviral Society-USA reviewed data published in peer-reviewed journals, presented by regulatory agencies, or presented as conference abstracts at peer-reviewed scientific conferences since the 2014 report, for new data or evidence that would change previous recommendations or their ratings. Comprehensive literature searches were conducted in the PubMed and EMBASE databases through April 2016. Recommendations were by consensus, and each recommendation was rated by strength and quality of the evidence. FINDINGS Newer data support the widely accepted recommendation that antiretroviral therapy should be started in all individuals with HIV infection with detectable viremia regardless of CD4 cell count. Recommended optimal initial regimens for most patients are 2 nucleoside reverse transcriptase inhibitors (NRTIs) plus an integrase strand transfer inhibitor (InSTI). Other effective regimens include nonnucleoside reverse transcriptase inhibitors or boosted protease inhibitors with 2 NRTIs. Recommendations for special populations and in the settings of opportunistic infections and concomitant conditions are provided. Reasons for switching therapy include convenience, tolerability, simplification, anticipation of potential new drug interactions, pregnancy or plans for pregnancy, elimination of food restrictions, virologic failure, or drug toxicities. Laboratory

Peer Relations in Peer Learning

Science.gov (United States)

Riese, Hanne; Samara, Akylina; Lillejord, Solvi

2012-01-01

Over the last decades, much research on peer learning practices has been conducted. Quantitative, experimental designs focusing on problems of cause and effect dominate. Consequently, effects on achievement are well documented, as is the influence of different conditions on the effect rate. In spite of the general acknowledgment of the importance…

Club Drugs and HIV/STD Infection: An Exploratory Analysis among Men Who Have Sex with Men in Changsha, China

Science.gov (United States)

Zheng, Jun; Zhao, Junshi; He, Jianmei; Zhang, Guoqiang; Tang, Xuemin

2015-01-01

Objective To evaluate current club drug use and its potential association with the transmission of HIV/STD among Changsha men who have sex with men (MSM). Method A cross-sectional survey was conducted by using self-administered questionnaires including information regarding socio-demographics, club drug use, high-risk behaviors, and HIV/STD infections. Multiple methods including venue-based, peer referral using “snowball” techniques, and internet advertisements were used to recruit study participants. Results Of the 826 participants, 177 (21.4%) reported that they had used club drugs at some time before or during sex in the past six months. MSM with young age, low education level, and seeking partners through the internet or bars were the main population who used drugs. Poppers were the most common drug used among Changsha MSM. The prevalence of HIV, syphilis, and herpes simplex virus-2 were higher among drug users. There were no significant differences in unprotected sexual intercourse and condom use between drug users and non-users. Compared with non-users, risk behaviors such as group sex, multiple sex partners, and sex with foreigners were more frequent among drug users. Conclusion Club drug use is common among Changsha MSM, and is related to unsafe sex activities and HIV/STD infection. It is necessary to build novel targeted HIV prevention strategies to monitor and reduce club drug use among MSM. PMID:25950912

Club Drugs and HIV/STD Infection: An Exploratory Analysis among Men Who Have Sex with Men in Changsha, China.

Directory of Open Access Journals (Sweden)

Xi Chen

Full Text Available To evaluate current club drug use and its potential association with the transmission of HIV/STD among Changsha men who have sex with men (MSM.A cross-sectional survey was conducted by using self-administered questionnaires including information regarding socio-demographics, club drug use, high-risk behaviors, and HIV/STD infections. Multiple methods including venue-based, peer referral using "snowball" techniques, and internet advertisements were used to recruit study participants.Of the 826 participants, 177 (21.4% reported that they had used club drugs at some time before or during sex in the past six months. MSM with young age, low education level, and seeking partners through the internet or bars were the main population who used drugs. Poppers were the most common drug used among Changsha MSM. The prevalence of HIV, syphilis, and herpes simplex virus-2 were higher among drug users. There were no significant differences in unprotected sexual intercourse and condom use between drug users and non-users. Compared with non-users, risk behaviors such as group sex, multiple sex partners, and sex with foreigners were more frequent among drug users.Club drug use is common among Changsha MSM, and is related to unsafe sex activities and HIV/STD infection. It is necessary to build novel targeted HIV prevention strategies to monitor and reduce club drug use among MSM.

Resource utilization and cost-effectiveness of counselor- vs. provider-based rapid point-of-care HIV screening in the emergency department.

Directory of Open Access Journals (Sweden)

Rochelle P Walensky

Full Text Available Routine HIV screening in emergency department (ED settings may require dedicated personnel. We evaluated the outcomes, costs and cost-effectiveness of HIV screening when offered by either a member of the ED staff or by an HIV counselor.We employed a mathematical model to extend data obtained from a randomized clinical trial of provider- vs. counselor-based HIV screening in the ED. We compared the downstream survival, costs, and cost-effectiveness of three HIV screening modalities: 1 no screening program; 2 an ED provider-based program; and 3 an HIV counselor-based program. Trial arm-specific data were used for test offer and acceptance rates (provider offer 36%, acceptance 75%; counselor offer 80%, acceptance 71%. Undiagnosed HIV prevalence (0.4% and linkage to care rates (80% were assumed to be equal between the screening modalities. Personnel costs were derived from trial-based resource utilization data. We examined the generalizability of results by conducting sensitivity analyses on offer and acceptance rates, undetected HIV prevalence, and costs.Estimated HIV screening costs in the provider and counselor arms averaged $8.10 and $31.00 per result received. The Provider strategy (compared to no screening had an incremental cost-effectiveness ratio of $58,700/quality-adjusted life year (QALY and the Counselor strategy (compared to the Provider strategy had an incremental cost-effectiveness ratio of $64,500/QALY. Results were sensitive to the relative offer and acceptance rates by strategy and the capacity of providers to target-screen, but were robust to changes in undiagnosed HIV prevalence and programmatic costs.The cost-effectiveness of provider-based HIV screening in an emergency department setting compares favorably to other US screening programs. Despite its additional cost, counselor-based screening delivers just as much return on investment as provider based-screening. Investment in dedicated HIV screening personnel is justified in

Resource utilization and cost-effectiveness of counselor- vs. provider-based rapid point-of-care HIV screening in the emergency department.

Science.gov (United States)

Walensky, Rochelle P; Morris, Bethany L; Reichmann, William M; Paltiel, A David; Arbelaez, Christian; Donnell-Fink, Laurel; Katz, Jeffrey N; Losina, Elena

2011-01-01

Routine HIV screening in emergency department (ED) settings may require dedicated personnel. We evaluated the outcomes, costs and cost-effectiveness of HIV screening when offered by either a member of the ED staff or by an HIV counselor. We employed a mathematical model to extend data obtained from a randomized clinical trial of provider- vs. counselor-based HIV screening in the ED. We compared the downstream survival, costs, and cost-effectiveness of three HIV screening modalities: 1) no screening program; 2) an ED provider-based program; and 3) an HIV counselor-based program. Trial arm-specific data were used for test offer and acceptance rates (provider offer 36%, acceptance 75%; counselor offer 80%, acceptance 71%). Undiagnosed HIV prevalence (0.4%) and linkage to care rates (80%) were assumed to be equal between the screening modalities. Personnel costs were derived from trial-based resource utilization data. We examined the generalizability of results by conducting sensitivity analyses on offer and acceptance rates, undetected HIV prevalence, and costs. Estimated HIV screening costs in the provider and counselor arms averaged $8.10 and $31.00 per result received. The Provider strategy (compared to no screening) had an incremental cost-effectiveness ratio of $58,700/quality-adjusted life year (QALY) and the Counselor strategy (compared to the Provider strategy) had an incremental cost-effectiveness ratio of $64,500/QALY. Results were sensitive to the relative offer and acceptance rates by strategy and the capacity of providers to target-screen, but were robust to changes in undiagnosed HIV prevalence and programmatic costs. The cost-effectiveness of provider-based HIV screening in an emergency department setting compares favorably to other US screening programs. Despite its additional cost, counselor-based screening delivers just as much return on investment as provider based-screening. Investment in dedicated HIV screening personnel is justified in situations

HIV/AIDS Competent Households: Interaction between a Health-Enabling Environment and Community-Based Treatment Adherence Support for People Living with HIV/AIDS in South Africa.

Science.gov (United States)

Masquillier, Caroline; Wouters, Edwin; Mortelmans, Dimitri; van Wyk, Brian; Hausler, Harry; Van Damme, Wim

2016-01-01

In the context of severe human resource shortages in HIV care, task-shifting and especially community-based support are increasingly being cited as potential means of providing durable care to chronic HIV patients. Socio-ecological theory clearly stipulates that-in all social interventions-the interrelatedness and interdependency between individuals and their immediate social contexts should be taken into account. People living with HIV/AIDS (PLWHA) seldom live in isolation, yet community-based interventions for supporting chronic HIV patients have largely ignored the social contexts in which they are implemented. Research is thus required to investigate such community-based support within its context. The aim of this study is to address this research gap by examining the way in which HIV/AIDS competence in the household hampers or facilitates community-based treatment adherence support. The data was analyzed carefully in accordance with the Grounded Theory procedures, using Nvivo 10. More specifically, we analyzed field notes from participatory observations conducted during 48 community-based treatment adherence support sessions in townships on the outskirts of Cape Town, transcripts of 32 audio-recorded in-depth interviews with PLWHA and transcripts of 4 focus group discussions with 36 community health workers (CHWs). Despite the fact that the CHWs try to present themselves as not being openly associated with HIV/AIDS services, results show that the presence of a CHW is often seen as a marker of the disease. Depending on the HIV/AIDS competence in the household, this association can challenge the patient's hybrid identity management and his/her attempt to regulate the interference of the household in the disease management. The results deepen our understanding of how the degree of HIV/AIDS competence present in a PLWHA's household affects the manner in which the CHW can perform his or her job and the associated benefits for the patient and his/her household

HIV/AIDS Competent Households: Interaction between a Health-Enabling Environment and Community-Based Treatment Adherence Support for People Living with HIV/AIDS in South Africa.

Directory of Open Access Journals (Sweden)

Caroline Masquillier

Full Text Available In the context of severe human resource shortages in HIV care, task-shifting and especially community-based support are increasingly being cited as potential means of providing durable care to chronic HIV patients. Socio-ecological theory clearly stipulates that-in all social interventions-the interrelatedness and interdependency between individuals and their immediate social contexts should be taken into account. People living with HIV/AIDS (PLWHA seldom live in isolation, yet community-based interventions for supporting chronic HIV patients have largely ignored the social contexts in which they are implemented. Research is thus required to investigate such community-based support within its context. The aim of this study is to address this research gap by examining the way in which HIV/AIDS competence in the household hampers or facilitates community-based treatment adherence support. The data was analyzed carefully in accordance with the Grounded Theory procedures, using Nvivo 10. More specifically, we analyzed field notes from participatory observations conducted during 48 community-based treatment adherence support sessions in townships on the outskirts of Cape Town, transcripts of 32 audio-recorded in-depth interviews with PLWHA and transcripts of 4 focus group discussions with 36 community health workers (CHWs. Despite the fact that the CHWs try to present themselves as not being openly associated with HIV/AIDS services, results show that the presence of a CHW is often seen as a marker of the disease. Depending on the HIV/AIDS competence in the household, this association can challenge the patient's hybrid identity management and his/her attempt to regulate the interference of the household in the disease management. The results deepen our understanding of how the degree of HIV/AIDS competence present in a PLWHA's household affects the manner in which the CHW can perform his or her job and the associated benefits for the patient and his

A Sandwich HIV p24 Amperometric Immunosensor Based on a Direct Gold Electroplating-Modified Electrode

Directory of Open Access Journals (Sweden)

Ning Gan

2012-05-01

Full Text Available Acquired immune deficiency syndrome (AIDS is a severe communicable immune deficiency disease caused by the human immune deficiency virus (HIV. The analysis laboratory diagnosis of HIV infection is a crucial aspect of controlling AIDS. The p24 antigen, the HIV-1 capsid protein, is of considerable diagnostic interest because it is detectable several days earlier than host-generated HIV antibodies following HIV exposure. We present herein a new sandwich HIV p24 immunosensor based on directly electroplating an electrode surface with gold nanoparticles using chronoamperometry, which greatly increased the conductivity and reversibility of the electrode. Under optimum conditions, the electrochemical signal showed a linear relationship with the concentration of p24, ranging from 0.01 ng/mL to 100 ng/mL (R > 0.99, and the detection limit was 0.008 ng/mL. Compared with ELISA, this method increased the sensitivity by more than two orders of magnitude (the sensitivity of ELISA for p24 is about 1 ng/mL. This immunosensor may be broadly applied to clinical samples, being distinguished by its ease of use, mild reaction conditions, guaranteed reproducibility, and good anti-interference ability.

A sandwich HIV p24 amperometric immunosensor based on a direct gold electroplating-modified electrode.

Science.gov (United States)

Zheng, Lei; Jia, Liyong; Li, Bo; Situ, Bo; Liu, Qinlan; Wang, Qian; Gan, Ning

2012-05-18

Acquired immune deficiency syndrome (AIDS) is a severe communicable immune deficiency disease caused by the human immune deficiency virus (HIV). The analysis laboratory diagnosis of HIV infection is a crucial aspect of controlling AIDS. The p24 antigen, the HIV-1 capsid protein, is of considerable diagnostic interest because it is detectable several days earlier than host-generated HIV antibodies following HIV exposure. We present herein a new sandwich HIV p24 immunosensor based on directly electroplating an electrode surface with gold nanoparticles using chronoamperometry, which greatly increased the conductivity and reversibility of the electrode. Under optimum conditions, the electrochemical signal showed a linear relationship with the concentration of p24, ranging from 0.01 ng/mL to 100 ng/mL (R > 0.99), and the detection limit was 0.008 ng/mL. Compared with ELISA, this method increased the sensitivity by more than two orders of magnitude (the sensitivity of ELISA for p24 is about 1 ng/mL). This immunosensor may be broadly applied to clinical samples, being distinguished by its ease of use, mild reaction conditions, guaranteed reproducibility, and good anti-interference ability.

Pentecostal Christianity (Faith-Based Organizations) And Hiv/Aids In ...

African Journals Online (AJOL)

This paper focused on Faith-based Organizations in the healing of persons living with HIV/ AIDS (PLWHA), using Overcomers' Christian Mission (OCM) as reference. The Study employed the transition theory as a conceptual base. Data were obtained from ethnographic life history of 2 persons previously living with HIV/AIDS ...

Differing HIV vulnerability among female sex workers in a high HIV burden Indian state.

Science.gov (United States)

Mamulwar, Megha; Godbole, Sheela; Bembalkar, Shilpa; Kamble, Pranil; Dulhani, Nisha; Yadav, Rajesh; Kadu, Chitra; Kumar, Pradeep; Lalikar, Shivraj; Acharya, Shrikala; Gangakhedkar, Raman; Risbud, Arun; Venkatesh, Srinivas

2018-01-01

The HIV sentinel surveillance [HSS] conducted in 2010-11 among female sex workers [FSW] in the state of Maharashtra, India provided an opportunity to assess characteristics of different types of FSWs and their HIV risk. It is important for India's National AIDS Control Program, to understand the differences in vulnerability among these FSW, in order to define more specific and effective risk reduction intervention strategies. Therefore, we analyzed data from HSS with the objective of understanding the HIV vulnerability among different types of FSW in Maharashtra. Cross sectional data collected as a part of HSS among FSWs in year 2010-11 from 21 sentinel sites in the state of Maharashtra were analyzed to understand the vulnerability and characteristics of different types of female sex workers based on their place of solicitation using multinomial logistic regression. While the HIV prevalence was 6.6% among all FSWs, it was 9.9% among brothel based [BB], 9% among street based [SB] and 3.1% and 3.7% among home based [HB], and bar based [Bar-B] sex workers respectively. SB FSWs were least likely to be located in HIV low burden districts [ANC] [ARRR: 0.61[95% CI: 0.49, 0.77

PERILAKU BULLYING DAN KARAKTER REMAJA SERTA KAITANNYA DENGAN KARAKTERISTIK KELUARGA DAN PEER GROUP

Directory of Open Access Journals (Sweden)

Karina Karina

2013-01-01

Full Text Available The purpose of this study was to determine the relationship among family characteristic, peer group, character (respectful and empathy, and bullying of youth at Bogor City. This study also aim to analyse the difference of peer group cohesiveness, bullying role, and character based on sex and school group. Fifty female and fifty male students, ages 16-18, from public and private vocational high school were selected by cluster random sampling. Result showed that there was significant difference at peer group cohesiveness between private and public schools, but no difference between male and female students. Female students more respectful than male and it were significantly different. Based on school group, there was no difference on their character. Female students also had higher score of bullying and they dominantly conducted verbal bullying. Ages of parents was significantly related to character of youth (respectful and empathy. Peer group cohesiveness was significantly related to bullying; the more cohessive to their peers, more bullying conducted by youth. It also showed that character were negatively significant related with bullying. 

The COBATEST network: a platform to perform monitoring and evaluation of HIV community-based testing practices in Europe and conduct operational research.

Science.gov (United States)

Fernàndez-López, L; Reyes-Urueña, J; Agustí, C; Kustec, T; Klavs, I; Casabona, C

2016-01-01

The European project "HIV community-based testing practices in Europe" (HIV-COBATEST) has contributed to the establishment of a network of community-based voluntary counselling and testing services (CBVCTs) that monitors and evaluates HIV testing activity in the communities. The objective of this paper is to describe the data that have been collected during 2014 by the COBATEST network in order to provide an insight into testing activity of CBVCTs in Europe. Members of the CBVCT network share common instruments for data collection and data entry. The network has a common database that allows global data analysis and comparison between different centres. In 2014, 40 CBVCTs of 18 European countries were participating in the network, and, from those, 20 CBVCTs were using the common COBATEST data collection tools. In these 20 CBVCTs, a total of 9266 HIV screening tests were performed on 8554 people, of which 1.58% (135/8554) were reactive and 51.1% (69/135) confirmed positive. Five cases were false positives, and 84.1% (58/69) of the confirmed positive cases were linked to care. Most of the tested individuals were men (70.8%), between 21 and 35 years of age (57.6%) and natives (67.1%). A higher proportion of men who had sex with men (MSM) (38.8%; 3267/8554) were tested compared to heterosexual men (27.7%) and women (23.5%). Rapid blood test was used in 78.5% of the cases and mostly performed in CBVCT offices (88.3%). Among sex workers (SWs), the percentage of reactive screening tests was particularly high (4.0%), especially among male SWs (7.7%) as compared to other risk groups, such as MSM (3.1%). The COBATEST network contributes to the availability of standardized information about the activity and impact of CBVCT centres in Europe. This information and standardized tools can help improve these services and inform decision-makers to better contextualize these interventions within their national HIV-prevention programmes.

Peer education programs in corrections: curriculum, implementation, and nursing interventions.

Science.gov (United States)

Dubik-Unruh, S

1999-01-01

Despite the prevalence of HIV and other infectious diseases in U.S. prisons, and the mix of infected and high-risk prisoners in crowded and volatile living conditions, federal and state prisons have reduced or eliminated prevention education programs addressing HIV and other infectious diseases for incarcerated populations. Nurses' knowledge, education, and licensure place them in a position to influence prison policy in developing and implementing educational programs for inmates and staff. Their role as advocates for patients in prison and their separation from the more punitive aspects of corrections also enable nurses to earn the trust of inmate populations. These factors identify nurses as the staff best suited within corrections to implement inmate prevention education. Training inmate educators to provide peer prevention and strategies for risk reduction have potential to modify inmate behaviors both within the facility and following release. Selection criteria for peer educator recruitment, prison-sensitive issues, and suggested training activities are discussed.

Number and timing of antenatal HIV testing: Evidence from a community-based study in Northern Vietnam

DEFF Research Database (Denmark)

Hanh, Nguyen Tt; Gammeltoft, Tine; Rasch, Vibeke

2011-01-01

scaled up to reach first level health facilities. METHODS: A cross-sectional community-based study was conducted among 1108 recently delivered mothers through face-to-face interviews following a structured questionnaire that focused on socio-economic characteristics, experiences of antenatal care and HIV...

Cross-cultural adaptation of an adolescent HIV prevention program: social validation of social contexts and behavior among Botswana adolescents.

Science.gov (United States)

St Lawrence, Janet S; Seloilwe, Esther; Magowe, Mabel; Dithole, Kefalotse; Kgosikwena, Billy; Kokoro, Elija; Lesaane, Dipuo

2013-08-01

An evidence-based HIV prevention intervention was adapted for Botswana youth with qualitative interviews, input from an adolescent panel, and social validation. Qualitative interviews were conducted with 40 boys and girls ages 13-19. An adolescent panel then drafted scenarios reflecting social situations described in the interviews that posed risk for HIV. A social validation sample (N = 65) then indicated the prevalence and difficulty of each situation. Youth described informational needs, pressures to use alcohol and drugs, peer pressure for unprotected sex, and intergenerational sex initiations as risk-priming situations. From 17% to 57% of the social validation sample had personally experienced the situations drafted by the adolescent panel. There were no differences in the ratings of boys versus girls, but youth over age 16 more often reported that they had experienced these risky situations. The results were embedded into the intervention. Major changes to the intervention resulted from this three-phase process.

Perceived medical benefit, peer/partner influence and safety and cost to access the service: client motivators for voluntary seeking of medical male circumcision in Iganga district eastern Uganda, a qualitative study.

Science.gov (United States)

Muhamadi, Lubega; Ibrahim, Musenze; Wabwire-Mangen, Fred; Peterson, Stefan; Reynolds, Steven J

2013-01-01

Although voluntary medical male circumcision (VMMC) in Iganga district was launched in 2010 as part of the Uganda national strategy to prevent new HIV infections with a target of having 129,896 eligible males circumcised by 2012, only 35,000 (27%) of the anticipated target had been circumcised by mid 2012. There was paucity of information on why uptake of VMMC was low in this setting where HIV awareness is presumably high. This study sought to understand motivators for uptake of VMMC from the perspective of the clients themselves in order to advocate for feasible approaches to expanding uptake of VMMC in Iganga district and similar settings. In Iganga district, we conducted seven key informant interviews with staff who work in the VMMC clinics and twenty in-depth interviews with clients who had accepted and undergone VMMC. Ten focus-group discussions including a total of 112 participants were also conducted with clients who had undergone VMMC. Motivators for uptake of VMMC in the perspective of the circumcised clients and the health care staff included: perceived medical benefit to those circumcised such as protection against acquiring HIV and other sexually transmitted diseases, peer/partner influence, sexual satisfaction and safety and cost to access the service. Since perceived medical benefit was a motivator for seeking VMMC, it can be used to strengthen campaigns for increasing uptake of VMMC. Peer influence could also be used in advocacy campaigns for VMMC expansion, especially using peers who have already undergone VMMC. There is need to ensure that safety and cost to access the service is affordable especially to rural poor as it was mentioned as a motivator for seeking VMMC.

Suicidal Ideation, Resilience, and Healthcare Implications for Newly Diagnosed HIV-Positive Men Who Have Sex with Men in China: A Qualitative Study.

Science.gov (United States)

Li, Haochu; Tucker, Joseph; Holroyd, Eleanor; Zhang, Jie; Jiang, Baofa

2017-05-01

Globally, suicidal ideation and behavior have been widely reported among people living with human immunodeficiency virus (HIV). Knowledge gaps exist regarding the longer life and resilience-related experiences of people living with HIV (PLWH). Specifically, there is a dearth of data about the interaction of perceived risk and resilient factors resulting in a wide spectrum of intentional suicidal ideation outcomes in a Chinese cultural context. This qualitative research drew from a larger ethnographic study of newly diagnosed HIV-positive men who have sex with men (MSM) in Mainland China. Interviews were conducted with 31 MSM within 6 months of diagnosis of HIV infection. Initial suicidal ideation was commonly reported with participants subsequently feeling more resilient to these thoughts through gaining a greater understanding of their prognosis and treatment. Post-HIV diagnosis, some participants reported forming new relationships and receiving increased support from their partners, friends, peers, families, and community-based organizations. At follow-up, these participants generally reported suicidal ideation had declined. However, participants who continued to express suicidal ideation perceived extended pressure from their families' expectations for them to engage in heterosexual marriages and parenthood. Furthermore, these men reported ongoing hardships in their daily life, unemployment, lack of social support, and isolation. Among this Mainland Chinese cohort of HIV-positive MSM, suicidal ideation may be a transient phenomenon experienced initially following HIV diagnosis that resolves with increased and specific familial, social, and service-based support. It is crucial to identify the causes of stress and social suffering associated with HIV diagnosis in order to reduce suicidal ideation. In China, action is needed to develop routine mental health screening and to increase services that support PLWH. Important services mechanism to accomplish this are

A peer evaluation of the community-based education programme for ...

African Journals Online (AJOL)

A peer evaluation of the community-based education programme for medical ... The University of Zimbabwe College of Health Sciences (UZCHS), Harare, which ... of community-based activities and the availability of a large teaching platform, ...

A model for HIV disclosure of a parent’s and/or a child’s illness

Directory of Open Access Journals (Sweden)

Grace Gachanja

2016-02-01

Full Text Available HIV prevalence in Kenya remains steady at 5.6% for adults 15 years and older, and 0.9% among children aged below 14 years. Parents and children are known to practice unprotected sex, which has implications for continued HIV spread within the country. Additionally, due to increased accessibility of antiretroviral therapy, more HIV-positive persons are living longer. Therefore, the need for HIV disclosure of a parent’s and/or a child’s HIV status within the country will continue for years to come. We conducted a qualitative phenomenological study to understand the entire process of disclosure from the time of initial HIV diagnosis of an index person within an HIV-affected family, to the time of full disclosure of a parent’s and/or a child’s HIV status to one or more HIV-positive, negative, or untested children within these households. Participants were purposively selected and included 16 HIV-positive parents, seven HIV-positive children, six healthcare professionals (physician, clinical officer, psychologist, registered nurse, social worker, and a peer educator, and five HIV-negative children. All participants underwent an in-depth individualized semistructured interview that was digitally recorded. Interviews were transcribed and analyzed in NVivo 8 using the modified Van Kaam method. Six themes emerged from the data indicating that factors such as HIV testing, living with HIV, evolution of disclosure, questions, emotions, benefits, and consequences of disclosure interact with each other and either impede or facilitate the HIV disclosure process. Kenya currently does not have guidelines for HIV disclosure of a parent’s and/or a child’s HIV status. HIV disclosure is a process that may result in poor outcomes in both parents and children. Therefore, understanding how these factors affect the disclosure process is key to achieving optimal disclosure outcomes in both parents and children. To this end, we propose an HIV disclosure model

Collaborative research to prevent HIV among male prison inmates and their female partners.

Science.gov (United States)

Grinstead, O A; Zack, B; Faigeles, B

1999-04-01

Despite the need for targeted HIV prevention interventions for prison inmates, institutional and access barriers have impeded development and evaluation of such programs. Over the past 6 years, the authors have developed a unique collaborative relationship to develop and evaluate HIV prevention interventions for prison inmates. The collaboration includes an academic research institution (the Center for AIDS Prevention Studies at the University of California, San Francisco), a community-based organization (Centerforce), and the staff and inmate peer educators inside a state prison. In this ongoing collaboration, the authors have developed and evaluated a series of HIV prevention interventions for prison inmates and for women who visit prison inmates. Results of these studies support the feasibility and effectiveness of HIV prevention programs for inmates and their partners both in prison and in the community. Access and institutional barriers to HIV intervention research in prisons can be overcome through the development of collaborative research partnerships.

Addressing Ebola-related stigma: lessons learned from HIV/AIDS.

Science.gov (United States)

Davtyan, Mariam; Brown, Brandon; Folayan, Morenike Oluwatoyin

2014-01-01

HIV/AIDS and Ebola Virus Disease (EVD) are contemporary epidemics associated with significant social stigma in which communities affected suffer from social rejection, violence, and diminished quality of life. To compare and contrast stigma related to HIV/AIDS and EVD, and strategically think how lessons learned from HIV stigma can be applied to the current EVD epidemic. To identify relevant articles about HIV/AIDS and EVD-related stigma, we conducted an extensive literature review using multiple search engines. PubMed was used to search for relevant peer-reviewed journal articles and Google for online sources. We also consulted the websites of the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and the National Institutes of Health to retrieve up-to-date information about EVD and HIV/AIDS. Many stigmatizing attitudes and behaviors directed towards those with EVD are strikingly similar to those with HIV/AIDS but there are significant differences worthy of discussion. Both diseases are life-threatening and there is no medical cure. Additionally misinformation about affected groups and modes of transmission runs rampant. Unlike in persons with EVD, historically criminalized and marginalized populations carry a disproportionately higher risk for HIV infection. Moreover, mortality due to EVD occurs within a shorter time span as compared to HIV/AIDS. Stigma disrupts quality of life, whether it is associated with HIV infection or EVD. When addressing EVD, we must think beyond the immediate clinical therapeutic response, to possible HIV implications of serum treatment. There are emerging social concerns of stigma associated with EVD infection and double stigma associated with EVD and HIV infection. Drawing upon lessons learned from HIV, we must work to empower and mobilize prominent members of the community, those who recovered from the disease, and organizations working at the grassroots level to disseminate clear and accurate

IPERS guidelines for the international peer review service. Second edition. Procedures for conducting independent peer reviews of probabilistic safety assessments

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-10-01

This publication describes the purposes and the objectives of an International Peer Review Service (IPERS) review. The main objective is first to assess whether important technological and methodological issues in the PSA are treated in an adequate manner and, second, whether specific conclusions and applications of the PSA are supported by the underlying technical analysis in an appropriate way. An important aspect for an IPERS review is the communication and exchange of views between the international experts carrying out the review and the members of the PSA team. This TECDOC is intended to give guidance on how an IPERS review is organized and conducted, it describes the steps needed to prepare the review and it highlights the PSA aspects which should be covered in detail. 30 refs, 1 fig., 2 tabs.

IPERS guidelines for the international peer review service. Second edition. Procedures for conducting independent peer reviews of probabilistic safety assessments

International Nuclear Information System (INIS)

1995-10-01

This publication describes the purposes and the objectives of an International Peer Review Service (IPERS) review. The main objective is first to assess whether important technological and methodological issues in the PSA are treated in an adequate manner and, second, whether specific conclusions and applications of the PSA are supported by the underlying technical analysis in an appropriate way. An important aspect for an IPERS review is the communication and exchange of views between the international experts carrying out the review and the members of the PSA team. This TECDOC is intended to give guidance on how an IPERS review is organized and conducted, it describes the steps needed to prepare the review and it highlights the PSA aspects which should be covered in detail. 30 refs, 1 fig., 2 tabs

Economic evaluation of HIV testing for men who have sex with men in community-based organizations - results from six European cities.

Science.gov (United States)

Perelman, Julian; Rosado, Ricardo; Amri, Omar; Morel, Stéphane; Rojas Castro, Daniela; Chanos, Sophocles; Cigan, Bojan; Lobnik, Miha; Fuertes, Ricardo; Pichon, François; Kaye, Per Slaaen; Agustí, Cristina; Fernàndez-López, Laura; Lorente, Nicolas; Casabona, Jordi

2017-08-01

The non-decreasing incidence of HIV among men who have sex with men (MSM) has motivated the emergence of Community Based Voluntary Counselling and Testing (CBVCT) services specifically addressed to MSM. The CBVCT services are characterized by facilitated access and linkage to care, a staff largely constituted by voluntary peers, and private not-for-profit structures outside the formal health system institutions. Encouraging results have been measured about their effectiveness, but these favourable results may have been obtained at high costs, questioning the opportunity to expand the experience. We performed an economic evaluation of HIV testing for MSM at CBVCT services, and compared them across six European cities. We collected retrospective data for six CBVCT services from six cities (Copenhagen, Paris, Lyon, Athens, Lisbon, and Ljubljana), for the year 2014, on the number of HIV tests and HIV reactive tests, and on all expenditures to perform the testing activities. The total costs of CBVCTs varied from 54,390€ per year (Ljubljana) to 245,803€ per year (Athens). The cost per HIV test varied from to 41€ (Athens) to 113€ (Ljubljana). The cost per HIV reactive test varied from 1966€ (Athens) to 9065€ (Ljubljana). Our results show that the benefits of CBVCT services are obtained at an acceptable cost, in comparison with the literature (values, mostly from the USA, range from 1600$ to 16,985$ per HIV reactive test in clinical and non-clinical settings). This result was transversal to several European cities, highlighting that there is a common CBVCT model, the cost of which is comparable regardless of the epidemiological context and prices. The CBVCT services represent an effective and "worth it" experience, to be continued and expanded in future public health strategies towards HIV.

Project Shikamana: Baseline Findings From a Community Empowerment-Based Combination HIV Prevention Trial Among Female Sex Workers in Iringa, Tanzania.

Science.gov (United States)

Kerrigan, Deanna; Mbwambo, Jessie; Likindikoki, Samuel; Beckham, Sarah; Mwampashi, Ard; Shembilu, Catherine; Mantsios, Andrea; Leddy, Anna; Davis, Wendy; Galai, Noya

2017-01-01

Community empowerment approaches have been found to be effective in responding to HIV among female sex workers (FSWs) in South Asia and Latin America. To date, limited rigorous evaluations of these approaches have been conducted in sub-Saharan Africa. A phase II community randomized controlled trial is being conducted in Iringa, Tanzania, to evaluate the effectiveness of a community empowerment-based combination HIV prevention model (Project Shikamana) among a stratified sample of HIV-infected and HIV-uninfected FSWs. Cohort members were recruited from entertainment venues across 2 communities in the region using time-location sampling. All study participants gave consent, and were surveyed and screened for HIV at baseline. Primary biological study outcomes are viral suppression among the HIV-infected and remaining free of HIV among HIV-uninfected women. A cohort of 496 FSWs was established and is currently under follow-up. Baseline HIV prevalence was 40.9% (203/496). Among HIV-infected FSWs, 30.5% (62/203) were previously aware of their HIV status; among those who were aware, 69.4% were on antiretroviral therapy (43/62); and for those on antiretroviral therapy, 69.8% (30/43) were virally suppressed. Factors associated with both HIV infection and viral suppression at baseline included community, age, number of clients, and substance use. Amount of money charged per client and having tested for sexually transmitted infection in the past 6 months were protective for HIV infection. Social cohesion among FSWs was protective for viral suppression. Significant gaps exist in HIV service coverage and progress toward reaching the 90-90-90 goals among FSWs in Iringa, Tanzania. Community empowerment approaches hold promise given the high HIV prevalence, limited services and stigma, discrimination, and violence.